Healthcare Provider Details

I. General information

NPI: 1932452570
Provider Name (Legal Business Name): CHERYL-ANN ECCLES RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2012
Last Update Date: 08/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 W 116TH ST. COLUMBIA UNIVERSITY
NEW YORK NY
10027
US

IV. Provider business mailing address

535 WEST 116TH ST. COLUMBIA UNIVERSITY
NEW YORK NY
10027
US

V. Phone/Fax

Practice location:
  • Phone: 212-342-3884
  • Fax: 212-947-7625
Mailing address:
  • Phone: 866-551-9700
  • Fax: 212-947-7625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744R1102X
TaxonomyResearch Study Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: