Provider Demographics
NPI:1558660787
Name:TISCHLER, ERIC (LAC)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:TISCHLER
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2565 ROUTE 212
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:NY
Mailing Address - Zip Code:12498-2115
Mailing Address - Country:US
Mailing Address - Phone:845-679-6210
Mailing Address - Fax:845-679-6214
Practice Address - Street 1:2565 ROUTE 212
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:NY
Practice Address - Zip Code:12498-2115
Practice Address - Country:US
Practice Address - Phone:845-679-6210
Practice Address - Fax:845-679-6214
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-28
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002998-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist