MEDICARE: MRS. EILEEN MARY HAWTHORN RNBC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WP0808X	Psychiatric/Mental Health Registered Nurse	408191-1	NY

General Provider Information

NPI Number	:	1063572832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. EILEEN MARY HAWTHORN RNBC

Provider Business Mailing Address
First Line	:	156 BEECHMONT DR
Second Line	:
City	:	NEW ROCHELLE
State	:	NY
Zip	:	10804-4406
Country	:	US
Telephone Number	:	914-632-7600
Fax Number	:	914-632-8837

Provider Business Practice Location Address
First Line	:	277 NORTH AVE
Second Line	:
City	:	NEW ROCHELLE
State	:	NY
Zip	:	10801-5103
Country	:	US
Telephone Number	:	914-632-7600
Fax Number	:	914-632-8837

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/11/2006
Last Update Date	:	07/08/2007

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