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General NPI Number Information
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NPI Number | 1467703801
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Entity Type | Individual
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Provider Name | MS. MAUREEN EISENBERG
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Gender | Female
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Dates
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Enumeration Date | 09/25/2012
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Last Update Date | 09/09/2013
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Provider Practice Location Address
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Address Line | 47-01 QUEENS BOULEVARD SUITE 303
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City | SUNNYSIDE
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State | NY
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Zip | 11104
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Country | US
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Telephone | 718-707-3434
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Fax | 718-707-3435
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Provider Business Mailing Address
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Address Line | 47-01 QUEENS BOULEVARD SUITE 303
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City | SUNNYSIDE
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State | NY
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Zip | 11104
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | F382350
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License Number State | NY
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