Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0201X | Pediatric Allergist | 49491 | WI |
NPI | 1770592545 |
---|---|
Provider Name | Mr. Eli M. Eisenstein |
First Address | Milwaukee, WI 53226-4837 |
Second Address | Milwaukee, WI 53226-3518 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2006 |
Last Update Date | 08/07/2007 |