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DR. EITEL EMANUEL PROVIDENCE M.D.
NPI 1215145552
Specialist in Brooklyn, NY

Active since May 18, 2007
3311 NEWKIRK AVE, BROOKLYN, NY 11203(718) 284-4423(718) 469-8708 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Dr. Eitel Emanuel Providence M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. EITEL EMANUEL PROVIDENCE M.D. (NPI 1215145552) is an individual specialist in Brooklyn, New York, licensed in New York (155818) and active in the NPI registry since May 2007.

NPPES Registry Identity

NPI1215145552
Entity TypeIndividualMale
Primary Taxonomy174400000X
Provider Legal NameDR. EITEL EMANUEL PROVIDENCECredential: M.D.
Location Address3311 NEWKIRK AVEBrooklyn, NY 11203-6108
Mailing Address3311 Newkirk AveBrooklyn, NY 11203-6108 · (718) 284-4423 · Fax (718) 469-8708
Phone(718) 284-4423
Fax(718) 469-8708
Sole ProprietorYes
Enumeration DateMay 18, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1215145552 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in NY · 155818
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
3311 NEWKIRK AVE, Brooklyn, NY 11203
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Other Identifiers 3

Medicare UPINA62576NY
Medicare ID-Type Unspecified38D041NY
Medicaid00877207NY

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Eitel Providence's NPI number?

The NPI number for Eitel Providence is 1215145552. It was assigned to this individual provider in the NPPES registry on May 18, 2007.

Where is Eitel Providence located?

Eitel Providence practices at 3311 Newkirk Ave, Brooklyn, NY 11203. The listed phone number is (718) 284-4423.

What is Eitel Providence's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Eitel Providence was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.