Provider Demographics
NPI:1306100409
Name:EISENBERGT, JOYCE E (MS)
Entity type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:E
Last Name:EISENBERGT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 WOODMERE BLVD. APT. 2A
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598
Mailing Address - Country:US
Mailing Address - Phone:516-780-4633
Mailing Address - Fax:
Practice Address - Street 1:37 WOODMERE BLVD
Practice Address - Street 2:APT.2A
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-2158
Practice Address - Country:US
Practice Address - Phone:516-780-4633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist