Provider Demographics
NPI:1073848818
Name:MCEACHIN, ELGIN
Entity Type:Individual
Prefix:MR
First Name:ELGIN
Middle Name:
Last Name:MCEACHIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1899 FULTON ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11233-3103
Mailing Address - Country:US
Mailing Address - Phone:718-221-1660
Mailing Address - Fax:718-221-1661
Practice Address - Street 1:1899 FULTON ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11233-3103
Practice Address - Country:US
Practice Address - Phone:718-221-1660
Practice Address - Fax:718-221-1661
Is Sole Proprietor?:No
Enumeration Date:2009-10-13
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician