Provider Demographics
NPI:1528246782
Name:EYBS, EDWARD J (RPH PRS)
Entity type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:J
Last Name:EYBS
Suffix:
Gender:M
Credentials:RPH PRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4837 BRADDOCK CT
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18902-6237
Mailing Address - Country:US
Mailing Address - Phone:267-885-6682
Mailing Address - Fax:215-230-4958
Practice Address - Street 1:1585 THE FAIRWAY
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046
Practice Address - Country:US
Practice Address - Phone:215-887-7877
Practice Address - Fax:215-230-4958
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-09
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037758183500000X
NJ28RI02222400183500000X
PARP450484183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJR22224OtherRPH LICENSE NUMBER
PARP450484OtherRPH LICENSE NUMBER
NY037758OtherRPH LICENSE NUMBER
NJ28RJ04065OtherCERTIFIED IMMUNIZER
PARPI010637OtherCERTIFIED IMMUNIZER