Basic Information
Provider Information
NPI: 1306966676
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: EICHLER
FirstName: ANDREA
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential: RNFA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 100 PARK STREET
Address2: GLENS FALLS HOSPITAL - CREDENTIALING
City: GLENS FALLS
State: NY
PostalCode: 128014413
CountryCode: US
TelephoneNumber: 5189265924
FaxNumber: 5189266983
Practice Location
Address1: 100 PARK STREET
Address2: GLENS FALLS HOSPITAL
City: GLENS FALLS
State: NY
PostalCode: 128014413
CountryCode: US
TelephoneNumber: 5189265600
FaxNumber: 5189265605
Other Information
ProviderEnumerationDate: 03/30/2007
LastUpdateDate: 02/10/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/10/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WR0006X273892NYY Nursing Service ProvidersRegistered NurseRegistered Nurse First Assistant

ID Information
IDTypeStateIssuerDescription
27389201NYNYS LICENSEOTHER


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