Eisdorfer, Jacob

Eisdorfer, Jacob is an sole proprietor health care provider with primary practice located at 1162 42Nd St , Brooklyn NY 11219-1213. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist Anesthesiologist, Dental Providers / Dentist. Dental Providers / Dentist Anesthesiologist is his primary health care specialty. Eisdorfer, Jacob can be contacted via phone (347) 209-7158.

Contact Information

Primary practice address
1162 42Nd St Brooklyn NY 11219-1213
Phone: (347) 209-7158
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist Anesthesiologist 1223D0004X 00055621 New York
Dental Providers / Dentist Anesthesiologist 1223D0004X 22DI02480400 New Jersey
Dental Providers / Dentist 122300000X 00055621 New York
Dental Providers / Dentist 122300000X 22DI02480400 New Jersey

Profile Details

NPI number 1881919728
LBN Legal business name Eisdorfer, Jacob
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 4th, 2010
Last updated Mar 24th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881919728 NPPES
New York MEDICAID 03355406

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