Healthcare Provider Details

I. General information

NPI: 1669667093
Provider Name (Legal Business Name): DAVID LEE EYSLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2007
Last Update Date: 09/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 S OYSTER BAY RD SUITE 106
HICKSVILLE NY
11801-3500
US

IV. Provider business mailing address

400 S OYSTER BAY RD SUITE 106
HICKSVILLE NY
11801-3500
US

V. Phone/Fax

Practice location:
  • Phone: 516-937-3881
  • Fax: 516-937-6155
Mailing address:
  • Phone: 516-937-3881
  • Fax: 516-937-6155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number175237
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: