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NPI Code Detail

MEDICARE: ILANA EISENBERG

MEDICARE: ILANA EISENBERG
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1679001515
Entity Type Code : Individual
Provider Name (Legal Business Name) : ILANA EISENBERG
Provider Business Mailing Address
First Line : 3 COLUMBUS CIR STE 1425
Second Line :
City : NEW YORK
State : NY
Zip : 10019-8720
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3 COLUMBUS CIR STE 1425
Second Line :
City : NEW YORK
State : NY
Zip : 10019-8720
Country : US
Telephone Number : 212-342-0111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2017
Last Update Date : 05/23/2017

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Directions to “ ILANA EISENBERG ” Practice Location

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