Provider Demographics
NPI:1275801730
Name:ANDROS, M EILEEN (RN)
Entity Type:Individual
Prefix:
First Name:M EILEEN
Middle Name:
Last Name:ANDROS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:648 NETHERWOOD RD
Mailing Address - Street 2:NETHERWOOD ELEMENTARY SCHOOL
Mailing Address - City:HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12538-2726
Mailing Address - Country:US
Mailing Address - Phone:845-229-4055
Mailing Address - Fax:845-229-2797
Practice Address - Street 1:648 NETHERWOOD RD
Practice Address - Street 2:NETHERWOOD ELEMENTARY SCHOOL
Practice Address - City:HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:12538-2726
Practice Address - Country:US
Practice Address - Phone:845-229-4055
Practice Address - Fax:845-229-2797
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-12
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY203297163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool