Provider Demographics
NPI:1386002798
Name:CZERWINSKI, EILEEN M (NP)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:M
Last Name:CZERWINSKI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 CIVIC CENTER BLVD
Mailing Address - Street 2:2 WEST
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-5127
Mailing Address - Country:US
Mailing Address - Phone:215-614-1618
Mailing Address - Fax:215-615-3380
Practice Address - Street 1:3400 CIVIC CENTER BLVD
Practice Address - Street 2:2 WEST
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-5127
Practice Address - Country:US
Practice Address - Phone:215-614-1618
Practice Address - Fax:215-615-3380
Is Sole Proprietor?:No
Enumeration Date:2016-02-01
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP015779363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner