1932138682 NPI number — FRANK EISINGER

Table of content: (NPI 1932138682)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932138682 NPI number — FRANK EISINGER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FRANK EISINGER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932138682
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/30/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5645 MAIN ST
Provider Second Line Business Mailing Address:
RM W238
Provider Business Mailing Address City Name:
FLUSHING
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11355-5045
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-670-1572
Provider Business Mailing Address Fax Number:
718-670-1864

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5645 MAIN ST
Provider Second Line Business Practice Location Address:
RM W238
Provider Business Practice Location Address City Name:
FLUSHING
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11355-5045
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-670-1572
Provider Business Practice Location Address Fax Number:
718-670-1864
Provider Enumeration Date:
07/02/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
EISINGER
Authorized Official First Name:
FRANK
Authorized Official Middle Name:
STEVE
Authorized Official Title or Position:
PA
Authorized Official Telephone Number:
718-670-1572

Provider Taxonomy Codes

  • Taxonomy code: 363AS0400X , with the licence number:  0037421 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)