Provider Demographics
NPI:1972723872
Name:EISENSTEIN, LAWRENCE MELVYN (M D)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:MELVYN
Last Name:EISENSTEIN
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 MECHANIC ST
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-1801
Mailing Address - Country:US
Mailing Address - Phone:732-747-7426
Mailing Address - Fax:732-747-9054
Practice Address - Street 1:21 MECHANIC ST
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1801
Practice Address - Country:US
Practice Address - Phone:732-747-7426
Practice Address - Fax:732-747-9054
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA264692084P0015X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine