Provider Demographics
NPI:1760841373
Name:EISENSTADT, ELLEN JACOBS (PHD)
Entity Type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:JACOBS
Last Name:EISENSTADT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 E 86TH ST
Mailing Address - Street 2:2B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-2175
Mailing Address - Country:US
Mailing Address - Phone:212-875-1544
Mailing Address - Fax:
Practice Address - Street 1:157 E 86TH ST
Practice Address - Street 2:2B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-2175
Practice Address - Country:US
Practice Address - Phone:212-875-1544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-11
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical