Provider Demographics
NPI:1558708511
Name:ESCHBACHER, KERRY (MA)
Entity Type:Individual
Prefix:MRS
First Name:KERRY
Middle Name:
Last Name:ESCHBACHER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:KERRY
Other - Middle Name:
Other - Last Name:SANTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 367
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12551-0367
Mailing Address - Country:US
Mailing Address - Phone:845-527-2029
Mailing Address - Fax:
Practice Address - Street 1:4885 ROUTE 9
Practice Address - Street 2:
Practice Address - City:STAATSBURG
Practice Address - State:NY
Practice Address - Zip Code:12580-6028
Practice Address - Country:US
Practice Address - Phone:845-527-2029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-31
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY671363121103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool