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General NPI Number Information
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NPI Number | 1578528881
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Entity Type | Individual
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Provider Name | WILLIAM H EAGEN M.A.
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Gender | Male
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Dates
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Enumeration Date | 04/19/2006
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Last Update Date | 10/14/2011
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Provider Practice Location Address
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Address Line | 58 MEADOWBROOK DR
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City | HUNTINGTON STATION
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State | NY
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Zip | 11746-2948
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Country | US
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Telephone | 631-549-2327
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Fax | 631-549-2327
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Provider Business Mailing Address
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Address Line | 58 MEADOWBROOK DR
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City | HUNTINGTON STATION
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State | NY
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Zip | 11746-2948
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Country | US
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Telephone | 631-549-2327
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Fax | 631-549-2327
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 000426-1
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License Number State | NY
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