Healthcare Provider Details

I. General information

NPI: 1689602229
Provider Name (Legal Business Name): JOSHUA AARON EISENBERG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 CAPITAL WAY STE 356
PENNINGTON NJ
08534-2521
US

IV. Provider business mailing address

2 CAPITAL WAY STE 356
PENNINGTON NJ
08534-2521
US

V. Phone/Fax

Practice location:
  • Phone: 609-537-6000
  • Fax: 609-537-6002
Mailing address:
  • Phone: 609-537-6000
  • Fax: 609-537-6002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number2006-00595
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number25MA09093500
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberMD417184
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number25MA09093500
License Number StateNJ
# 5
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number2006-00595
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: