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General NPI Number Information
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NPI Number | 1316816606
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Entity Type | Organization
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Legal Business Name | THE EAST COAST CENTER FOR COSMETIC BREAST SURGERY
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Dates
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Enumeration Date | 11/04/2025
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 2375 WOODWARD ST STE 102
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City | PHILADELPHIA
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State | PA
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Zip | 19115-5105
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Country | US
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Telephone | 215-969-2005
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Fax | 215-969-2006
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Provider Business Mailing Address
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Address Line | 2375 WOODWARD ST STE 102
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City | PHILADELPHIA
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State | PA
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Zip | 19115-5105
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Country | US
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Telephone | 215-969-2005
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Fax | 215-969-2006
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TED EISENBERG
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Credential | DO
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Telephone | 215-969-2005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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