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NPI Code Detail

MEDICARE: DR. JASON ZEUS EISENBERG MD

MEDICARE: DR. JASON ZEUS EISENBERG MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician276966NY

General Provider Information

NPI Number : 1255567087
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JASON ZEUS EISENBERG MD
Provider Business Mailing Address
First Line : 234 E 149TH ST
Second Line :
City : BRONX
State : NY
Zip : 10451-5589
Country : US
Telephone Number : 718-579-5006
Fax Number :
Provider Business Practice Location Address
First Line : 234 E 149TH ST
Second Line :
City : BRONX
State : NY
Zip : 10451-5589
Country : US
Telephone Number : 718-579-5006
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2009
Last Update Date : 09/02/2022

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