Provider Demographics
NPI:1942244819
Name:EINSTEIN, ERIC BRANDT (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:BRANDT
Last Name:EINSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 CONNECTICUT AVENUE
Mailing Address - Street 2:ADULT MEDICINE-NCHC
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06854
Mailing Address - Country:US
Mailing Address - Phone:203-899-1770
Mailing Address - Fax:203-852-3989
Practice Address - Street 1:120 CONNECTICUT AVENUE
Practice Address - Street 2:ADULT MEDICINE-NCHC
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06854
Practice Address - Country:US
Practice Address - Phone:203-899-1770
Practice Address - Fax:203-852-3989
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT23682207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001236827Medicaid
CT110007727Medicare ID - Type UnspecifiedMEDICARE BILLING NUMBER
CT001236827Medicaid