Provider Demographics
NPI:1598771305
Name:JANEC, EILEEN MARGARET (MD)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:MARGARET
Last Name:JANEC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 WESTCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10604-2901
Mailing Address - Country:US
Mailing Address - Phone:914-682-6466
Mailing Address - Fax:914-681-5222
Practice Address - Street 1:111 BROADWAY
Practice Address - Street 2:2ND FL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10006-1901
Practice Address - Country:US
Practice Address - Phone:212-263-9700
Practice Address - Fax:212-263-9701
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH13014207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1012416Medicaid
NH30205906Medicaid
NHRE8625Medicare ID - Type Unspecified
VT1012416Medicaid