Provider Demographics
NPI:1679263529
Name:EISENBERG, MARK JEFFERY (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:JEFFERY
Last Name:EISENBERG
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1303 SUMMIT CIRCLE DR
Mailing Address - Street 2:ANNA EISENBERG APT
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618
Mailing Address - Country:US
Mailing Address - Phone:514-294-8540
Mailing Address - Fax:514-340-7534
Practice Address - Street 1:JEWISH GENERAL HOSPITAL ROOM H421
Practice Address - Street 2:3755 COTE ST CATHERINE RD
Practice Address - City:MONTREAL
Practice Address - State:QC
Practice Address - Zip Code:H4V 2V9
Practice Address - Country:CA
Practice Address - Phone:514-294-8540
Practice Address - Fax:514-340-7534
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-12
Last Update Date:2023-05-12
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Provider Licenses
StateLicense IDTaxonomies
NY166867-01207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty