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NPI Code Detail

MEDICARE: DR. NANCY EOS M.D.

MEDICARE:  DR. NANCY  EOS  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician220644NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447238191
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NANCY EOS M.D.
Provider Business Mailing Address
First Line : PO BOX 426
Second Line :
City : HIGH FALLS
State : NY
Zip : 12440-0426
Country : US
Telephone Number : 845-292-0522
Fax Number :
Provider Business Practice Location Address
First Line : 2821 ROUTE 209
Second Line :
City : KINGSTON
State : NY
Zip : 12401-7661
Country : US
Telephone Number : 845-292-0522
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2006
Last Update Date : 06/07/2019

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