Provider Demographics
NPI:1659584233
Name:EISENBERG, DANIEL M (CHIROPRACTIC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:M
Last Name:EISENBERG
Suffix:
Gender:M
Credentials:CHIROPRACTIC
Other - Prefix:DR
Other - First Name:DANIEL
Other - Middle Name:M
Other - Last Name:EISENBERG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CHIROPRACTIC
Mailing Address - Street 1:625 E FORDHAM RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-5049
Mailing Address - Country:US
Mailing Address - Phone:718-933-1900
Mailing Address - Fax:718-563-4039
Practice Address - Street 1:625 E FORDHAM RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-5049
Practice Address - Country:US
Practice Address - Phone:718-933-1900
Practice Address - Fax:718-563-4039
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010719-2111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor