Basic Information
| Provider Information | |||||||||
| NPI: | 1619642287 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EISENBERG | ||||||||
| FirstName: | ABRAHAM | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2405 AVENUE P FL 2 | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112291605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9144202707 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3709 FLATLANDS AVE | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112343507 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7184447766 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/15/2021 | ||||||||
| LastUpdateDate: | 12/14/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/14/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 348109 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.