Provider Demographics
NPI:1841382595
Name:EISNER, DEBRA ELLEN (DPM)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:ELLEN
Last Name:EISNER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 BROWN ST STE 501
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-6790
Mailing Address - Country:US
Mailing Address - Phone:978-372-3201
Mailing Address - Fax:978-372-3301
Practice Address - Street 1:62 BROWN ST STE 501
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-6790
Practice Address - Country:US
Practice Address - Phone:978-372-3201
Practice Address - Fax:978-372-3301
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1583213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
713925OtherTUFTS
Y70672OtherBLUE CROSS
713925OtherTUFTS
J58712Medicare UPIN