Provider Demographics
NPI:1992866610
Name:ROBERT A AISENSTAT MD&HELENE M AISENSTAT MDD PC
Entity Type:Organization
Organization Name:ROBERT A AISENSTAT MD&HELENE M AISENSTAT MDD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:AISENSTAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-849-4700
Mailing Address - Street 1:5000 CEDAR PLAZA PKWY
Mailing Address - Street 2:STE 300
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-3854
Mailing Address - Country:US
Mailing Address - Phone:314-849-4700
Mailing Address - Fax:314-849-4700
Practice Address - Street 1:5000 CEDAR PLAZA PKWY
Practice Address - Street 2:STE 300
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-3854
Practice Address - Country:US
Practice Address - Phone:314-849-4700
Practice Address - Fax:314-849-4700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty