Provider Demographics
NPI:1962793786
Name:EISENBERG, MARINA A (MD)
Entity type:Individual
Prefix:DR
First Name:MARINA
Middle Name:A
Last Name:EISENBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARINA
Other - Middle Name:ALEKSEYEVNA
Other - Last Name:BELYAYEV
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2000 AUBURN DR STE 100
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4328
Mailing Address - Country:US
Mailing Address - Phone:162-831-0120
Mailing Address - Fax:
Practice Address - Street 1:2000 AUBURN DR STE 100
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4328
Practice Address - Country:US
Practice Address - Phone:216-831-0120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-27
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301096197207W00000X
390200000X
OH35.126040207WX0110X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program