1154534261 NPI number — BAILA EISENBERG-COHEN LCSW

Table of content: BAILA EISENBERG-COHEN LCSW (NPI 1154534261)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154534261 NPI number — BAILA EISENBERG-COHEN LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EISENBERG-COHEN
Provider First Name:
BAILA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
EISENBERG
Provider Other First Name:
BAILA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1154534261
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5722 MELVIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15217-2213
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
917-549-0421
Provider Business Mailing Address Fax Number:
412-422-6425

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 JHF DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15217-2950
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-904-5286
Provider Business Practice Location Address Fax Number:
412-904-5025
Provider Enumeration Date:
05/07/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  CW015615 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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