Provider Demographics
NPI:1184006405
Name:EINSBRUCH, DANIELLE ELYSE
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:ELYSE
Last Name:EINSBRUCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 LUTH TER
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-6608
Mailing Address - Country:US
Mailing Address - Phone:973-476-9628
Mailing Address - Fax:
Practice Address - Street 1:22 LUTH TER
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-6608
Practice Address - Country:US
Practice Address - Phone:973-476-9628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-23
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency