Eileen Phoenix

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

EILEEN PHOENIX

Practice address

134 Clarke Ave
Staten Island, NY 10306-1112

Phone

(718) 619-6808

Fax

(718) 667-5365

NPI assigned

Feb 5, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Eileen Susan Phoenix, L.AC.NPI 1639348154

Title

Owner

Phone

(718) 619-6808

Specialties & licenses 1

Addresses

Other names 1

• Clear Light Acupuncture Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eileen Susan Phoenix, L.AC.

  • Acupuncturist
  • Staten Island, NY
  • NPI 1639348154
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1517788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517788800000",
    "number": "1205335205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 CLARKE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103061112",
            "telephone_number": "718-619-6808",
            "fax_number": "718-667-5365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 CLARKE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103061112",
            "telephone_number": "718-619-6808",
            "fax_number": "718-667-5365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EILEEN PHOENIX",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-05",
        "last_updated": "2018-02-05",
        "status": "A",
        "authorized_official_last_name": "PHOENIX",
        "authorized_official_first_name": "EILEEN",
        "authorized_official_middle_name": "SUSAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-619-6808",
        "authorized_official_credential": "L.AC."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clear Light Acupuncture",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christine Eick, LPN
• Dyala Sophia Eid, M.S.
• Marwenhassan Eid, MD
• Mohamed Eid, PT
• Danielle Marie Eikeseth
• Eric Eilenberg
• Stefanie Eilerman, PHARMD
• Galina Eilyuk
• Bruce Elliot Eisenberg, DC
• Jesse Rose Eisenberg, MD

• Health Service Clinic/Center in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Health Service Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.