Healthcare Provider Details

I. General information

NPI: 1386014579
Provider Name (Legal Business Name): ALLANDRA-MARIE S MC EACHRANE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2015
Last Update Date: 09/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 SAINT MARKS PL
NEW YORK NY
10003-7902
US

IV. Provider business mailing address

17261 HIGHLAND AVE
JAMAICA NY
11432-2861
US

V. Phone/Fax

Practice location:
  • Phone: 212-982-3470
  • Fax:
Mailing address:
  • Phone: 347-596-3775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: