Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 286257 | NY |
NPI | 1013469824 |
---|---|
Provider Name | Dr. Andrew Murray Eisenthal |
First Address | New York, NY 10026-1121 |
Second Address | New York, NY 10026-1121 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2016 |
Last Update Date | 27/10/2016 |