Basic Information
Provider Information
NPI: 1275553372
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: EISENSTEIN
FirstName: NORMAN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: PHD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
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OtherLastNameType:  
Mailing Information
Address1: 151 KNOLLCROFT RD
Address2: VANJ HEALTHCARE SYSTEM MENTAL HEALTH AND BEHAVIORAL SCI
City: LYONS
State: NJ
PostalCode: 079395001
CountryCode: US
TelephoneNumber: 9086470180
FaxNumber: 9086045255
Practice Location
Address1: 151 KNOLLCROFT RD
Address2: VANJ HEALTHCARE SYSTEM MENTAL HEALTH AND BEHAVIORAL SCI
City: LYONS
State: NJ
PostalCode: 079395001
CountryCode: US
TelephoneNumber: 9086470180
FaxNumber: 9086045255
Other Information
ProviderEnumerationDate: 07/20/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103G00000X35SI00248900NJY Behavioral Health & Social Service ProvidersClinical Neuropsychologist 

No ID Information.


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