Provider Demographics
NPI:1215101738
Name:EICHERT, JULIAN-ALLSTON DENNISON
Entity type:Individual
Prefix:MR
First Name:JULIAN-ALLSTON
Middle Name:DENNISON
Last Name:EICHERT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2166 S 12TH ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-8701
Mailing Address - Country:US
Mailing Address - Phone:610-969-0300
Mailing Address - Fax:
Practice Address - Street 1:2166 S 12TH ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-8701
Practice Address - Country:US
Practice Address - Phone:610-969-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN564840163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health