Provider Demographics
NPI:1821061490
Name:EICHENFIELD, ANDREW H (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:H
Last Name:EICHENFIELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 E 90TH ST APT 6A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-5136
Mailing Address - Country:US
Mailing Address - Phone:212-289-0359
Mailing Address - Fax:
Practice Address - Street 1:11100 EUCLID AVENUE
Practice Address - Street 2:MAILSTOP 6090
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106
Practice Address - Country:US
Practice Address - Phone:216-844-3645
Practice Address - Fax:216-201-5338
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.1353562080P0216X
NY1444432080P0216X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0216XAllopathic & Osteopathic PhysiciansPediatricsPediatric Rheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01151880Medicaid
NYB39918Medicare UPIN
NY01151880Medicaid