Provider Demographics
NPI:1881956654
Name:LITVACK, EILEEN FRAN
Entity type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:FRAN
Last Name:LITVACK
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:EILEEN
Other - Middle Name:FRAN
Other - Last Name:HORTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1726 MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-5020
Mailing Address - Country:US
Mailing Address - Phone:516-483-9808
Mailing Address - Fax:
Practice Address - Street 1:1726 MEADOW LN
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-5020
Practice Address - Country:US
Practice Address - Phone:516-483-9808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist