Provider Demographics
NPI:1285866632
Name:EISENBERG-PAPKA, REBECCA MARISSA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:MARISSA
Last Name:EISENBERG-PAPKA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 RIDGEDALE AVE
Mailing Address - Street 2:
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-1355
Mailing Address - Country:US
Mailing Address - Phone:973-900-3505
Mailing Address - Fax:973-379-7598
Practice Address - Street 1:215 RIDGEDALE AVE
Practice Address - Street 2:
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-1355
Practice Address - Country:US
Practice Address - Phone:973-900-3505
Practice Address - Fax:973-379-7598
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-19
Last Update Date:2009-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ4712103TC0700X
NY015078103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical