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General NPI Number Information
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NPI Number | 1619642287
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Entity Type | Individual
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Provider Name | ABRAHAM EISENBERG FNP
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Gender | Male
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Dates
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Enumeration Date | 08/15/2021
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Last Update Date | 06/25/2024
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Provider Practice Location Address
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Address Line | 16 SANZ TOWN RD
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City | LAKEWOOD
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State | NJ
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Zip | 08701-3178
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Country | US
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Telephone | 908-989-0038
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 995
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City | LAKEWOOD
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State | NJ
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Zip | 08701-0995
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Country | US
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Telephone | 89-890-0038
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 348109
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 26NJ14870200
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License Number State | NJ
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