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NPI Code Detail

MEDICARE: DR. NOAM EITAN M.D.

MEDICARE:  DR. NOAM  EITAN  M.D.
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
12084P0800XPsychiatry Physician206352NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245249978
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NOAM EITAN M.D.
Provider Business Mailing Address
First Line : 302 SUGARLOAF MOUNTAIN RD
Second Line :
City : CHESTER
State : NY
Zip : 10918-2503
Country : US
Telephone Number : 516-770-0302
Fax Number :
Provider Business Practice Location Address
First Line : 302 SUGARLOAF MOUNTAIN RD
Second Line :
City : CHESTER
State : NY
Zip : 10918-2503
Country : US
Telephone Number : 516-770-0301
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2006
Last Update Date : 06/21/2026

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Directions to “ DR. NOAM EITAN M.D.” Practice Location

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