Provider Demographics
NPI:1346894441
Name:EIGEL, MAYA OLIVIA
Entity Type:Individual
Prefix:
First Name:MAYA
Middle Name:OLIVIA
Last Name:EIGEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1408 LAKE SHORE DR APT A
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43204-4835
Mailing Address - Country:US
Mailing Address - Phone:614-668-9732
Mailing Address - Fax:
Practice Address - Street 1:7648 SUMMERWOOD DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-1842
Practice Address - Country:US
Practice Address - Phone:614-512-1388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-26
Last Update Date:2019-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0345923Medicaid