Provider Demographics
NPI:1407238421
Name:MOREIRA EYNG, GISELA (MD)
Entity Type:Individual
Prefix:
First Name:GISELA
Middle Name:
Last Name:MOREIRA EYNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 N 30TH ST FL 2
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-2136
Mailing Address - Country:US
Mailing Address - Phone:531-355-6509
Mailing Address - Fax:531-355-0035
Practice Address - Street 1:555 N 30TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-2136
Practice Address - Country:US
Practice Address - Phone:531-355-6509
Practice Address - Fax:531-355-0035
Is Sole Proprietor?:No
Enumeration Date:2015-06-25
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.0705422080P0008X
390200000X
NE33817
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No2080P0008XAllopathic & Osteopathic PhysiciansPediatricsNeurodevelopmental Disabilities
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program