Provider Demographics
NPI:1619041035
Name:EICHEL, STEVE KENNETH DUBROW (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEVE
Middle Name:KENNETH DUBROW
Last Name:EICHEL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 NOTTINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-7404
Mailing Address - Country:US
Mailing Address - Phone:302-368-9136
Mailing Address - Fax:866-538-9048
Practice Address - Street 1:409 NOTTINGHAM RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-7404
Practice Address - Country:US
Practice Address - Phone:302-368-9136
Practice Address - Fax:866-538-9048
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEB1-595103TC1900X
PAPS003893-L103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA199781OtherPA BLUE SHIELD PROVIDER #