Healthcare Provider Details

I. General information

NPI: 1689212003
Provider Name (Legal Business Name): ALLISON EISENBERG PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2019
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

262 CENTRAL PARK W STE 1E
NEW YORK NY
10024-3512
US

IV. Provider business mailing address

2020 BROADWAY APT 5B
NEW YORK NY
10023-5011
US

V. Phone/Fax

Practice location:
  • Phone: 718-371-0007
  • Fax: 917-268-9687
Mailing address:
  • Phone: 516-776-1222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number026164
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: