Healthcare Provider Details

I. General information

NPI: 1871628990
Provider Name (Legal Business Name): ESTHER B. EISENSTEIN M.D.,
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18458 VIA DI SORRENTO
BOCA RATON FL
33496-1965
US

IV. Provider business mailing address

18458 VIA DI SORRENTO
BOCA RATON FL
33496-1965
US

V. Phone/Fax

Practice location:
  • Phone: 561-852-1912
  • Fax: 561-852-1912
Mailing address:
  • Phone: 561-852-1912
  • Fax: 561-852-1912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME36613
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME3613
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: