Provider Demographics
NPI:1134372329
Name:EISENBERG, CAROLINE ROSE (RD)
Entity type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:ROSE
Last Name:EISENBERG
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 ROOSEVELT BLVD
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08009
Mailing Address - Country:US
Mailing Address - Phone:856-470-0665
Mailing Address - Fax:
Practice Address - Street 1:127 BERLIN CROSS KEYS RD
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:NJ
Practice Address - Zip Code:08009
Practice Address - Country:US
Practice Address - Phone:856-470-0665
Practice Address - Fax:856-767-3867
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-31
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJCDR- 01025437133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered