MEDICARE: DR. JULIA EILENBERG M.D.

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	2084P0800X	Psychiatry Physician	182560	NY

General Provider Information

NPI Number	:	1902949241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JULIA EILENBERG M.D.

Provider Business Mailing Address
First Line	:	22 GARDEN ST
Second Line	:	SUITE #4
City	:	RHINEBECK
State	:	NY
Zip	:	12572-1300
Country	:	US
Telephone Number	:	845-876-7822
Fax Number	:	845-876-8850

Provider Business Practice Location Address
First Line	:	22 GARDEN ST
Second Line	:	SUITE #4
City	:	RHINEBECK
State	:	NY
Zip	:	12572-1300
Country	:	US
Telephone Number	:	845-876-7822
Fax Number	:	845-876-8850

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

Provider Enumeration Date	:	02/15/2007
Last Update Date	:	07/08/2007

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