Provider Demographics
NPI:1982058178
Name:EISEN, CAROLE L (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLE
Middle Name:L
Last Name:EISEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:CAROLE
Other - Middle Name:EISEN
Other - Last Name:GOODKIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:ONE MEDICAL CENTER BLVD., CARE MANAGEMENT DEPT.
Mailing Address - Street 2:CROZER CHESTER MEDICAL CENTER
Mailing Address - City:UPLAND
Mailing Address - State:PA
Mailing Address - Zip Code:19013-3995
Mailing Address - Country:US
Mailing Address - Phone:610-447-2618
Mailing Address - Fax:610-447-6028
Practice Address - Street 1:ONE MEDICAL CENTER BLVD., CARE MANAGEMENT DEPT.
Practice Address - Street 2:CROZER CHESTER MEDICAL CENTER
Practice Address - City:UPLAND
Practice Address - State:PA
Practice Address - Zip Code:19013-3995
Practice Address - Country:US
Practice Address - Phone:610-447-2618
Practice Address - Fax:610-447-6028
Is Sole Proprietor?:No
Enumeration Date:2016-04-14
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAME017193E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine