Provider Demographics
NPI:1023345493
Name:EICHHORN, MARTINA
Entity type:Individual
Prefix:MRS
First Name:MARTINA
Middle Name:
Last Name:EICHHORN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 CATES RD
Mailing Address - Street 2:APTMT. B
Mailing Address - City:THORNDIKE
Mailing Address - State:ME
Mailing Address - Zip Code:04986-3428
Mailing Address - Country:US
Mailing Address - Phone:207-568-1049
Mailing Address - Fax:207-568-1049
Practice Address - Street 1:83 CATES RD
Practice Address - Street 2:APTMT. B
Practice Address - City:THORNDIKE
Practice Address - State:ME
Practice Address - Zip Code:04986-3428
Practice Address - Country:US
Practice Address - Phone:207-568-1049
Practice Address - Fax:207-568-1049
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-05
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant