Healthcare Provider Details

I. General information

NPI: 1578734414
Provider Name (Legal Business Name): DR MORRIS EISEN, D.O.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2008
Last Update Date: 04/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 E EVESHAM RD STE 406
VOORHEES NJ
08043-4505
US

IV. Provider business mailing address

114 MORNINGSIDE DR
CHERRY HILL NJ
08003-1022
US

V. Phone/Fax

Practice location:
  • Phone: 856-772-9600
  • Fax: 856-772-9650
Mailing address:
  • Phone: 856-772-9600
  • Fax: 856-772-9650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberMB38543
License Number StateNJ

VIII. Authorized Official

Name: DR. MORRIS EISEN
Title or Position: DOCTOR
Credential: D.O.
Phone: 856-772-9600