Eisenman, Mallory Lynn
Eisenman, Mallory Lynn is an sole proprietor health care provider with primary practice located at 1900 Rittenhouse Sq Suite C3, Philadelphia PA 19103-5767. She recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as her primary health care specialty. Eisenman, Mallory Lynn can be contacted via phone (215) 735-3668.Contact Information
Primary practice address
1900 Rittenhouse Sq Suite C3
Philadelphia PA 19103-5767
Phone: (215) 735-3668
Fax: (215) 735-1838
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | SC0021671 | Pennsylvania |
Profile Details
| NPI number | 1487655445 |
|---|---|
| LBN Legal business name | Eisenman, Mallory Lynn |
| Credentials | Doctor of Podiatric Medicine (DPM) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 2nd, 2005 |
| Last updated | Mar 11th, 2014 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487655445 | NPPES |
| Pennsylvania | Other | 0480001090 | RAILROAD MEDICARE |
| Pennsylvania | Other | 000492696 | RAILROAD MEDICARE |
| Pennsylvania | Other | 402696 | RAILROAD MEDICARE |
| Pennsylvania | MEDICAID | 010346300001 | RAILROAD MEDICARE |
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