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:
Health care specialties
| Specialty | Code | License # | 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 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487659744 | NPPES |
| Pennsylvania | MEDICAID | 1187399 | |
| Pennsylvania | Other | 815507 | |
| Pennsylvania | Other | 851436 |
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