Provider Demographics
NPI:1659584316
Name:EISCHEN, BRENDA BAUER (PSYD)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:BAUER
Last Name:EISCHEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:BRENDA
Other - Middle Name:
Other - Last Name:BAUER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:500 E 77TH ST
Mailing Address - Street 2:APT 1908
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10162-0025
Mailing Address - Country:US
Mailing Address - Phone:212-864-0838
Mailing Address - Fax:
Practice Address - Street 1:329 E 62ND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-7705
Practice Address - Country:US
Practice Address - Phone:212-838-4333
Practice Address - Fax:212-838-7158
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program