Provider Demographics
NPI:1487928917
Name:EISENSTEIN, LAURA STELLA OSOROJOS (DOM, LAC)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:STELLA OSOROJOS
Last Name:EISENSTEIN
Suffix:
Gender:F
Credentials:DOM, LAC
Other - Prefix:DR
Other - First Name:STELLA
Other - Middle Name:OSOROJOS
Other - Last Name:EISENSTEIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DOM, LAC
Mailing Address - Street 1:3608 MONTOUR ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-1931
Mailing Address - Country:US
Mailing Address - Phone:717-558-0748
Mailing Address - Fax:
Practice Address - Street 1:3608 MONTOUR ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17111-1931
Practice Address - Country:US
Practice Address - Phone:717-558-0748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-01
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOM000130171100000X
NM986171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist