Provider Demographics
NPI:1407371198
Name:EISEL, DANIELLE CATHRYN (PHARMD)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:CATHRYN
Last Name:EISEL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2929 STODDARD ST APT B
Mailing Address - Street 2:
Mailing Address - City:COPENHAGEN
Mailing Address - State:NY
Mailing Address - Zip Code:13626-2907
Mailing Address - Country:US
Mailing Address - Phone:1315-767-8297
Mailing Address - Fax:
Practice Address - Street 1:842 STATE ST
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-2843
Practice Address - Country:US
Practice Address - Phone:315-783-5246
Practice Address - Fax:315-788-8768
Is Sole Proprietor?:No
Enumeration Date:2017-08-03
Last Update Date:2017-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY062939183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist