Individual
DR. MARIE T EAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
20 VANDERVENTER AVE STE 100E, PORT WASHINGTON, NY 11050-3752
(516) 944-9460
(516) 944-9427
Mailing address
8 ORCHARD FARM ROAD, PORT WASHINGTON, NY 11050-3752
(516) 944-8097
(516) 883-8501
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X003730-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CO3730-1B
WORKERS COMP. AUTHORIZATI
NY
Enumeration date
11/07/2006
Last updated
06/04/2008
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