Healthcare Provider Details

I. General information

NPI: 1134601487
Provider Name (Legal Business Name): PATRICIA EICHINGER LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2018
Last Update Date: 12/01/2021
Certification Date: 12/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SAINT ANNE'S GPU AT NEW ENGLAND SINAI HOSPITAL 150 YORK STREET
STOUGHTON MA
02072
US

IV. Provider business mailing address

1200 CENTRE ST
BOSTON MA
02131-1000
US

V. Phone/Fax

Practice location:
  • Phone: 782-297-1677
  • Fax: 781-297-1684
Mailing address:
  • Phone: 617-363-8614
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number118807
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: