MEDICARE: MRS. KEREN EISENBERG M.A.P.T.

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
1	225100000X	Physical Therapist	0050711	NY

General Provider Information

NPI Number	:	1831107358
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KEREN EISENBERG M.A.P.T.

Provider Business Mailing Address
First Line	:	40 EXCHANGE PL
Second Line	:	SUITE 728
City	:	NEW YORK
State	:	NY
Zip	:	10005-2701
Country	:	US
Telephone Number	:	212-425-1060
Fax Number	:	646-527-9021

Provider Business Practice Location Address
First Line	:	40 EXCHANGE PL
Second Line	:	SUITE 728
City	:	NEW YORK
State	:	NY
Zip	:	10005-2701
Country	:	US
Telephone Number	:	212-425-1060
Fax Number	:	646-527-9021

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	10/20/2016

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