Provider Demographics
NPI:1609021203
Name:EICHEL, SADIE A (PA)
Entity Type:Individual
Prefix:
First Name:SADIE
Middle Name:A
Last Name:EICHEL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 GREEN ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:GARDNER
Mailing Address - State:MA
Mailing Address - Zip Code:01440-1396
Mailing Address - Country:US
Mailing Address - Phone:978-630-4455
Mailing Address - Fax:978-669-0046
Practice Address - Street 1:250 GREEN ST
Practice Address - Street 2:SUITE 202
Practice Address - City:GARDNER
Practice Address - State:MA
Practice Address - Zip Code:01440-1396
Practice Address - Country:US
Practice Address - Phone:978-630-4455
Practice Address - Fax:978-669-0046
Is Sole Proprietor?:No
Enumeration Date:2008-11-24
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA4340363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical