Provider Demographics
NPI:1144224551
Name:STONE, EILEEN D (MD)
Entity Type:Individual
Prefix:DR
First Name:EILEEN
Middle Name:D
Last Name:STONE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1001 W FAYETTE ST STE 400
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13204-2866
Mailing Address - Country:US
Mailing Address - Phone:315-479-5070
Mailing Address - Fax:315-701-2520
Practice Address - Street 1:739 IRVING AVE
Practice Address - Street 2:STE 200
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1668
Practice Address - Country:US
Practice Address - Phone:315-479-5070
Practice Address - Fax:315-701-2520
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2021-03-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY157796207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00993682Medicaid
110132828Medicare PIN
NY00993682Medicaid
J400027459Medicare PIN
NYC59307Medicare UPIN