Provider Demographics
NPI:1538216056
Name:CHALEFF-WEIN, EILEEN (LAC)
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:
Last Name:CHALEFF-WEIN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 WHEATFIELD DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:MILFORD
Mailing Address - State:PA
Mailing Address - Zip Code:18337-7694
Mailing Address - Country:US
Mailing Address - Phone:570-409-1239
Mailing Address - Fax:570-409-1850
Practice Address - Street 1:102 WHEATFIELD DR
Practice Address - Street 2:SUITE B
Practice Address - City:MILFORD
Practice Address - State:PA
Practice Address - Zip Code:18337-7694
Practice Address - Country:US
Practice Address - Phone:570-409-1239
Practice Address - Fax:570-409-1850
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY02087-1171100000X
PAAK000636171100000X
NJ25MZ00032100171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2G6303OtherEMPIREBLUE