Provider Demographics
NPI:1528222700
Name:BEARE, EILEEN MARIE (RN)
Entity Type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:MARIE
Last Name:BEARE
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 1:411 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CATSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12414-1363
Mailing Address - Country:US
Mailing Address - Phone:518-719-3638
Mailing Address - Fax:518-719-3780
Practice Address - Street 1:411 MAIN ST
Practice Address - Street 2:
Practice Address - City:CATSKILL
Practice Address - State:NY
Practice Address - Zip Code:12414-1363
Practice Address - Country:US
Practice Address - Phone:518-719-3638
Practice Address - Fax:518-719-3780
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY222256163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator