Provider Demographics
NPI:1376627372
Name:ELI KIRSHNER MD PC
Entity Type:Organization
Organization Name:ELI KIRSHNER MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ELI
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRSHNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-664-3900
Mailing Address - Street 1:400 OLD HOOK RD
Mailing Address - Street 2:SUITE1-6
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-2732
Mailing Address - Country:US
Mailing Address - Phone:201-664-3900
Mailing Address - Fax:201-664-7800
Practice Address - Street 1:400 OLD HOOK RD
Practice Address - Street 2:SUITE 1-6
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-2732
Practice Address - Country:US
Practice Address - Phone:201-664-3900
Practice Address - Fax:201-664-7800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA062155207R00000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ078606Medicare PIN