Provider Demographics
NPI:1447586839
Name:EISENBROCK, HOWARD (DO)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:
Last Name:EISENBROCK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 MECHANIC ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-1869
Mailing Address - Country:US
Mailing Address - Phone:732-268-7130
Mailing Address - Fax:
Practice Address - Street 1:65 MECHANIC ST
Practice Address - Street 2:SUITE 105
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1869
Practice Address - Country:US
Practice Address - Phone:732-268-7130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-20
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB09846400207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery