Individual
MS. EILEEN M. STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
161 FORT WASHINGTON AVE FL 7, NEW YORK, NY 10032-3729
(212) 305-9246
(212) 030-5584
Mailing address
25 HOFFMAN ST, MAPLEWOOD, NJ 07040-1138
(973) 378-8244
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
381742
NY
Other
Enumeration date
03/22/2007
Last updated
07/08/2007
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