Provider Demographics
NPI:1376732438
Name:PELOVITZ, EILEEN (RN)
Entity Type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:
Last Name:PELOVITZ
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 1:7 PIPE HILL CT UNIT C
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-5260
Mailing Address - Country:US
Mailing Address - Phone:410-484-4852
Mailing Address - Fax:
Practice Address - Street 1:6401 YORK RD
Practice Address - Street 2:3RD FLOOR
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-2152
Practice Address - Country:US
Practice Address - Phone:410-887-3485
Practice Address - Fax:410-377-8296
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-15
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR041525163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse