Provider Demographics
NPI:1598911000
Name:EISLEY, ANDREA CARMINA (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:CARMINA
Last Name:EISLEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 ROUTE 6 UNIT 100
Mailing Address - Street 2:
Mailing Address - City:BALDWIN PLACE
Mailing Address - State:NY
Mailing Address - Zip Code:10505-1028
Mailing Address - Country:US
Mailing Address - Phone:914-628-8942
Mailing Address - Fax:914-628-5788
Practice Address - Street 1:80 ROUTE 6 UNIT 100
Practice Address - Street 2:
Practice Address - City:BALDWIN PLACE
Practice Address - State:NY
Practice Address - Zip Code:10505-1028
Practice Address - Country:US
Practice Address - Phone:914-628-8942
Practice Address - Fax:914-628-5788
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-15
Last Update Date:2008-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052785183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist