Provider Demographics
NPI:1437278413
Name:SAQQAL, EILEEN A (MSED,TVI)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:A
Last Name:SAQQAL
Suffix:
Gender:F
Credentials:MSED,TVI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 ALBION PL
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10302-1819
Mailing Address - Country:US
Mailing Address - Phone:718-876-0783
Mailing Address - Fax:
Practice Address - Street 1:281 PORT RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10302-1707
Practice Address - Country:US
Practice Address - Phone:718-442-6006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WV0400XEye and Vision Services ProvidersOptometristVision Therapy