Provider Demographics
NPI:1932879004
Name:EISENHOWER, EMILY HELEN (OD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:HELEN
Last Name:EISENHOWER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 HORSESHOE PIKE
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:PA
Mailing Address - Zip Code:17078-9040
Mailing Address - Country:US
Mailing Address - Phone:717-473-3802
Mailing Address - Fax:717-641-3074
Practice Address - Street 1:2901 HORSESHOE PIKE
Practice Address - Street 2:
Practice Address - City:PALMYRA
Practice Address - State:PA
Practice Address - Zip Code:17078-9040
Practice Address - Country:US
Practice Address - Phone:717-473-3802
Practice Address - Fax:717-641-3074
Is Sole Proprietor?:No
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG003852152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist