Provider Demographics
NPI:1811121148
Name:REID, EILEEN MARIE (RN)
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:MARIE
Last Name:REID
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 MC CLAY RD
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:NY
Mailing Address - Zip Code:12834-3522
Mailing Address - Country:US
Mailing Address - Phone:518-692-7354
Mailing Address - Fax:
Practice Address - Street 1:11 MC CLAY RD
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:NY
Practice Address - Zip Code:12834-3522
Practice Address - Country:US
Practice Address - Phone:518-692-7354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-14
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY382009-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse