Provider Demographics
NPI:1992069868
Name:BERCHIN, EILEEN
Entity type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:
Last Name:BERCHIN
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 1:1229 E 66TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-5604
Mailing Address - Country:US
Mailing Address - Phone:718-209-9545
Mailing Address - Fax:
Practice Address - Street 1:1229 E 66TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5604
Practice Address - Country:US
Practice Address - Phone:718-209-9545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-26
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist