Basic Information
| Provider Information | |||||||||
| NPI: | 1689255606 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EICHENBERG | ||||||||
| FirstName: | TZEIDEL | ||||||||
| MiddleName: | BROWN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 150 BERGEN ST. | ||||||||
| Address2: | RUTGERS NJMS UNIVERSITY HOSPITAL ROOM I-248 | ||||||||
| City: | NEWARK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9739726056 | ||||||||
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| Practice Location | |||||||||
| Address1: | 150 BERGEN ST. | ||||||||
| Address2: | RUTGERS NJMS UNIVERSITY HOSPITAL ROOM I-248 | ||||||||
| City: | NEWARK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 071010710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9739726056 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2021 | ||||||||
| LastUpdateDate: | 04/20/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/25/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.