Provider Demographics
NPI:1417751991
Name:EICHWALD, ALISIA
Entity type:Individual
Prefix:
First Name:ALISIA
Middle Name:
Last Name:EICHWALD
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 FROSTFIELD PL
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-1609
Mailing Address - Country:US
Mailing Address - Phone:631-912-7350
Mailing Address - Fax:
Practice Address - Street 1:3410 DE REIMER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-1518
Practice Address - Country:US
Practice Address - Phone:347-301-6217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician