Provider Demographics
NPI:1225258643
Name:EICKHORST, KIMBERLY MAY (MD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:MAY
Last Name:EICKHORST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:170 MOUNT PLEASANT RD STE 201
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06470-1408
Mailing Address - Country:US
Mailing Address - Phone:203-792-4151
Mailing Address - Fax:203-792-4155
Practice Address - Street 1:170 MOUNT PLEASANT RD STE 201
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:CT
Practice Address - Zip Code:06470-1408
Practice Address - Country:US
Practice Address - Phone:203-792-4151
Practice Address - Fax:203-792-4155
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJPENDING207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology