Provider Demographics
NPI:1376733261
Name:EISENSTEIN, RONALD LESTER (OPTICIAN)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:LESTER
Last Name:EISENSTEIN
Suffix:
Gender:M
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 WASHINGTON HEIGHTS MED CTR
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-5633
Mailing Address - Country:US
Mailing Address - Phone:410-848-6660
Mailing Address - Fax:410-848-5314
Practice Address - Street 1:200 WASHINGTON HEIGHTS MED CTR
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5633
Practice Address - Country:US
Practice Address - Phone:410-848-6660
Practice Address - Fax:410-848-5314
Is Sole Proprietor?:No
Enumeration Date:2007-07-27
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA840156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician