Provider Demographics
NPI:1154788974
Name:CAMERON, EILEEN PATRICIA (MSED)
Entity type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:PATRICIA
Last Name:CAMERON
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263-267 PORT RICHMOND AVEUNE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10302
Mailing Address - Country:US
Mailing Address - Phone:718-981-8117
Mailing Address - Fax:718-981-9344
Practice Address - Street 1:263-267 PORT RICHMOND AVEUNE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10302
Practice Address - Country:US
Practice Address - Phone:718-981-8117
Practice Address - Fax:718-981-9344
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-25
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor