1730104985 NPI number — MS. ERIN FINK EICHHORN M.S., C.G.C.

Table of content: MS. ERIN FINK EICHHORN M.S., C.G.C. (NPI 1730104985)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730104985 NPI number — MS. ERIN FINK EICHHORN M.S., C.G.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EICHHORN
Provider First Name:
ERIN
Provider Middle Name:
FINK
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.S., C.G.C.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FINK
Provider Other First Name:
ERIN
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MS, CGC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1730104985
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/17/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
877 EXECUTIVE CENTER DR W STE 206
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ST PETERSBURG
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33702-2472
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-407-6502
Provider Business Mailing Address Fax Number:
760-203-1191

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
877 EXECUTIVE CENTER DR W STE 206
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ST PETERSBURG
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33702-2472
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-407-6502
Provider Business Practice Location Address Fax Number:
760-203-1191
Provider Enumeration Date:
07/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 170300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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