Provider Demographics
NPI:1073773297
Name:ESCHLER, DEIRDRE COCKS (MD)
Entity type:Individual
Prefix:
First Name:DEIRDRE
Middle Name:COCKS
Last Name:ESCHLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1559
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-0989
Mailing Address - Country:US
Mailing Address - Phone:631-827-8625
Mailing Address - Fax:
Practice Address - Street 1:STONY BROOK INTERNIST
Practice Address - Street 2:UFPC SMUMC, HSC LEVEL 15, RM 60
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-8154
Practice Address - Country:US
Practice Address - Phone:631-444-1665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-11
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY257601207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program