Provider Demographics
NPI:1801965892
Name:EISENSTEIN, NAOMI (PHD)
Entity type:Individual
Prefix:DR
First Name:NAOMI
Middle Name:
Last Name:EISENSTEIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:NAOMI
Other - Middle Name:
Other - Last Name:SOBEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5555 N PORT WASHINGTON RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MILWAUKII
Mailing Address - State:WI
Mailing Address - Zip Code:53217
Mailing Address - Country:US
Mailing Address - Phone:414-962-6100
Mailing Address - Fax:414-962-6470
Practice Address - Street 1:5555 N PORT WASHINGTON RD
Practice Address - Street 2:SUITE 200
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53217
Practice Address - Country:US
Practice Address - Phone:414-962-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1390057103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42136100Medicaid
WI42136100Medicaid