Individual
EILEEN DAETSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3980 SHERIDAN DR, 6TH FLOOR, AMHERST, NY 14226-1727
(716) 882-6544
(716) 882-6833
Mailing address
3980 SHERIDAN DR, 6TH FLOOR, AMHERST, NY 14226-1727
(716) 882-6544
(716) 882-6833
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F300156-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00026511101
EXCELLUS UNIVERA
NY
01
—
005603231
HEALTH NOW
NY
05
—
01816059
—
NY
01
—
9512106
INDEPENDENT HEALTH
NY
Enumeration date
09/27/2006
Last updated
09/23/2019
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