Eaton, Jack H

Eaton, Jack H is an individual health care provider with primary practice located at 176 Lee Ave , Brooklyn NY 11211. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Eaton, Jack H can be contacted via phone (718) 855-3070.

Contact Information

Primary practice address
176 Lee Ave Brooklyn NY 11211
Phone: (718) 855-3070
Fax: (718) 596-4657
Website:
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Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 0238781 New York

Profile Details

NPI number 1720068232
LBN Legal business name Eaton, Jack H
Credentials RPH
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 19th, 2006
Last updated Jun 16th, 2009 - about 17 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 1720068232 NPPES
New York MEDICAID 00263410
New York Other 3326673
New York Other 023878

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