Provider Demographics
NPI:1952456089
Name:EICHLER, LAUREN ANN (PT)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:ANN
Last Name:EICHLER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:LAUREN
Other - Middle Name:ANN
Other - Last Name:ORLASKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:60 GROVELAND PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:SOUND BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11789-2540
Mailing Address - Country:US
Mailing Address - Phone:631-285-1542
Mailing Address - Fax:631-285-1542
Practice Address - Street 1:60 GROVELAND PARK BLVD
Practice Address - Street 2:
Practice Address - City:SOUND BEACH
Practice Address - State:NY
Practice Address - Zip Code:11789-2540
Practice Address - Country:US
Practice Address - Phone:631-285-1542
Practice Address - Fax:631-285-1542
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY01697312251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02603285Medicaid