Provider Demographics
NPI:1962877670
Name:EISELE, CHERYLE
Entity type:Individual
Prefix:DR
First Name:CHERYLE
Middle Name:
Last Name:EISELE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 OLD TUCKAHOE RD
Mailing Address - Street 2:
Mailing Address - City:WOODBINE
Mailing Address - State:NJ
Mailing Address - Zip Code:08270-3132
Mailing Address - Country:US
Mailing Address - Phone:609-932-1392
Mailing Address - Fax:
Practice Address - Street 1:280 OLD TUCKAHOE RD
Practice Address - Street 2:
Practice Address - City:WOODBINE
Practice Address - State:NJ
Practice Address - Zip Code:08270-3132
Practice Address - Country:US
Practice Address - Phone:609-932-1392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-07
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NC03116800364SW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SW0102XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistWomen's Health