Ellen Eisenberg
Dentist - General Practice Oral and Maxillofacial Pathology
263 Farmington Ave
Farmington
, Connecticut 06030-0001
Ellen Eisenberg
Dentist - General Practice Oral and Maxillofacial Pathology
263 Farmington Ave
Farmington
, Connecticut 06030-0001
(860) 679-1610
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About
Features
Specialties
- General Practice
- Oral and Maxillofacial Pathology
Languages spoken
- English
Location
First Address
- Ellen Eisenberg
- 263 Farmington Ave Provider Enrollment
- Farmington, CT
- Zip : 06030-2212
- Fax : (860) 679-1610
- Phone : (860) 679-7503
Second Address
- Ellen Eisenberg
- 263 Farmington Ave
- Farmington, CT
- Zip : 06030-0001
- Fax : (860) 679-4760
- Phone : (860) 679-2952
Reviews
FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 1223G0001X | General Practice | 005451 | CT |
| N | 213EG0000X | General Practice | 005451 | CT |
| Y | 1223P0106X | Oral and Maxillofacial Pathology | 005451 | CT |
National Provider Identifier
| NPI | 1013913367 |
|---|---|
| Provider Name | Ellen Eisenberg |
| First Address | Farmington, CT 06030-2212 |
| Second Address | Farmington, CT 06030-0001 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 22/06/2005 |
| Last Update Date | 10/05/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 2054518 | (05) | CT |
| U28044 | (02) | CT |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.