Basic Information
| Provider Information | |||||||||
| NPI: | 1932452570 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ECCLES | ||||||||
| FirstName: | CHERYL-ANN | ||||||||
| MiddleName: | |||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 535 WEST 116TH ST. | ||||||||
| Address2: | COLUMBIA UNIVERSITY | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8665519700 | ||||||||
| FaxNumber: | 2129477625 | ||||||||
| Practice Location | |||||||||
| Address1: | 535 W 116TH ST. | ||||||||
| Address2: | COLUMBIA UNIVERSITY | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2123423884 | ||||||||
| FaxNumber: | 2129477625 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/19/2012 | ||||||||
| LastUpdateDate: | 08/06/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1744R1102X | Y | Other Service Providers | Specialist | Research Study |
No ID Information.