Provider Demographics
NPI:1427131234
Name:EINHORN, JILL LORI (DPM)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:LORI
Last Name:EINHORN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2616 AVENUE U
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-5010
Mailing Address - Country:US
Mailing Address - Phone:718-891-2706
Mailing Address - Fax:718-648-9041
Practice Address - Street 1:2616 AVENUE U
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-5010
Practice Address - Country:US
Practice Address - Phone:718-891-2706
Practice Address - Fax:718-648-9041
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004759213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
01047729OtherAMERI-GROUP
4C4582OtherHEALTHNET
MCA1092-01OtherAMERICHOICE
NY01281896Medicaid
N004759OtherHIP
KS679OtherOXFORD
N004759-B15OtherHEALTHFIRST
0281103000OtherAMERIHEALTH
030004759NY01OtherANTHEM
164339OtherELDERPLAN
54N1151OtherNEIGHBORHOOD
SP6923OtherCENTER CARE
NYP00656527OtherRAIL ROAD MEDICARE
P53762OtherBLUE CROSS
1193321OtherUNITED HEALTHCARE
1499912OtherGHI
270120101OtherHEALTHPLUS
1499912OtherGHI
SP6923OtherCENTER CARE
5360180001Medicare NSC