Basic Information
| Provider Information | |||||||||
| NPI: | 1134618143 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YEISER | ||||||||
| FirstName: | ELEANORA | ||||||||
| MiddleName: | ROBINSON | ||||||||
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| Mailing Information | |||||||||
| Address1: | 135 S BRYN MAWR AVE STE 205 | ||||||||
| Address2: | |||||||||
| City: | BRYN MAWR | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190103129 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4843372885 | ||||||||
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| Practice Location | |||||||||
| Address1: | 48 - 50 FAIRFIELD STREET | ||||||||
| Address2: | |||||||||
| City: | MONCLAIR | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07042 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9737448511 | ||||||||
| FaxNumber: | 9737446356 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2018 | ||||||||
| LastUpdateDate: | 02/18/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Q00000X | 25MB11050200 | NJ | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.