Provider Demographics
NPI:1104045558
Name:EICHEN, ANN ELIZABETH (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:ELIZABETH
Last Name:EICHEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 OXFORD RD
Mailing Address - Street 2:
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-2217
Mailing Address - Country:US
Mailing Address - Phone:610-668-0797
Mailing Address - Fax:
Practice Address - Street 1:300 E LANCASTER AVE
Practice Address - Street 2:SUITE 311
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-2139
Practice Address - Country:US
Practice Address - Phone:610-642-4252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS008197L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAEP047663Medicare ID - Type Unspecified