Eagen, Jeremiah W

Eagen, Jeremiah W is an individual health care provider with primary practice located at 802 Jefferson Ave , Scranton PA 18510-1038. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Eagen, Jeremiah W can be contacted via phone (570) 348-0360.

Contact Information

Primary practice address
802 Jefferson Ave Scranton PA 18510-1038
Phone: (570) 348-0360
Fax: (570) 348-0362
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X MD-021443-E Pennsylvania

Profile Details

NPI number 1487659744
LBN Legal business name Eagen, Jeremiah W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2005
Last updated Apr 23rd, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487659744 NPPES
Pennsylvania MEDICAID 1187399
Pennsylvania Other 815507
Pennsylvania Other 851436

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