Healthcare Provider Details

I. General information

NPI: 1619041035
Provider Name (Legal Business Name): STEVE KENNETH DUBROW EICHEL PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 NOTTINGHAM RD
NEWARK DE
19711-7404
US

IV. Provider business mailing address

409 NOTTINGHAM RD
NEWARK DE
19711-7404
US

V. Phone/Fax

Practice location:
  • Phone: 302-368-9136
  • Fax: 866-538-9048
Mailing address:
  • Phone: 302-368-9136
  • Fax: 866-538-9048

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberB1-595
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPS003893-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: