Healthcare Provider Details

I. General information

NPI: 1306540497
Provider Name (Legal Business Name): SYLVIA ESHAK WILLIAM ESHAK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2023
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 BRIGHTON RD STE 400
CLIFTON NJ
07012-1670
US

IV. Provider business mailing address

PO BOX 14564
BELFAST ME
04915-4038
US

V. Phone/Fax

Practice location:
  • Phone: 862-249-4904
  • Fax: 862-249-4903
Mailing address:
  • Phone: 212-524-7767
  • Fax: 212-643-8201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MA13012800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: