Provider Demographics
NPI:1699774950
Name:EICHMAN, GERARD T (MD)
Entity type:Individual
Prefix:DR
First Name:GERARD
Middle Name:T
Last Name:EICHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:954 TEANECK RD
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-4504
Mailing Address - Country:US
Mailing Address - Phone:201-833-2300
Mailing Address - Fax:201-833-7600
Practice Address - Street 1:954 TEANECK RD
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4504
Practice Address - Country:US
Practice Address - Phone:201-833-2300
Practice Address - Fax:201-833-7600
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA56809207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6515801Medicaid
777935M7AMedicare ID - Type Unspecified
NJ6515801Medicaid