MEDICARE: BARUCH EISENBERG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	NY177977	NY

General Provider Information

NPI Number	:	1588680474
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARUCH EISENBERG MD

Provider Business Mailing Address
First Line	:	1815 S CLINTON AVE STE 445
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14618-5719
Country	:	US
Telephone Number	:	585-461-0720
Fax Number	:	585-461-0729

Provider Business Practice Location Address
First Line	:	1815 S CLINTON AVE STE 445
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14618-5719
Country	:	US
Telephone Number	:	585-461-0720
Fax Number	:	585-461-0729

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	08/06/2025

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