Provider Demographics
NPI:1386445435
Name:EYNISFELD, DAVID
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:EYNISFELD
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 KIMBERLY CT APT 76
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-5055
Mailing Address - Country:US
Mailing Address - Phone:732-757-5932
Mailing Address - Fax:
Practice Address - Street 1:13 KIMBERLY CT APT 76
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-5055
Practice Address - Country:US
Practice Address - Phone:732-757-5932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-21-50660103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst