Provider Demographics
NPI:1942483649
Name:PERRY, EILEEN LOUISE (NP)
Entity Type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:LOUISE
Last Name:PERRY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:EILEEN
Other - Middle Name:LOUISE
Other - Last Name:TEHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:327 CENTRAL PARK W
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-7631
Mailing Address - Country:US
Mailing Address - Phone:212-663-6604
Mailing Address - Fax:212-663-7259
Practice Address - Street 1:327 CENTRAL PARK W
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-7631
Practice Address - Country:US
Practice Address - Phone:212-663-6604
Practice Address - Fax:212-663-7259
Is Sole Proprietor?:No
Enumeration Date:2007-12-17
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY577092163W00000X
NYF420862363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse