Healthcare Provider Details

I. General information

NPI: 1285673285
Provider Name (Legal Business Name): BARRY I EISENSTEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 01/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 BROAD BRANCH RD NW
WASHINGTON DC
20015-2539
US

IV. Provider business mailing address

5601 BROAD BRANCH RD NW
WASHINGTON DC
20015-2539
US

V. Phone/Fax

Practice location:
  • Phone: 202-506-7673
  • Fax:
Mailing address:
  • Phone: 202-506-7673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number152926
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD038483
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: