Basic Information
| Provider Information | |||||||||
| NPI: | 1851579510 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JOSEPH EICHENBAUM MD AND DAVID WEINSTOCK MD PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 253 BROADWAY | ||||||||
| Address2: | |||||||||
| City: | LYNBROOK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115633243 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5165966100 | ||||||||
| FaxNumber: | 5165996989 | ||||||||
| Practice Location | |||||||||
| Address1: | 253 BROADWAY | ||||||||
| Address2: | |||||||||
| City: | LYNBROOK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115633243 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5165966100 | ||||||||
| FaxNumber: | 5165996989 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/05/2008 | ||||||||
| LastUpdateDate: | 04/14/2008 | ||||||||
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| AuthorizedOfficialLastName: | EICHENBAUM | ||||||||
| AuthorizedOfficialFirstName: | JOSEPH | ||||||||
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| AuthorizedOfficialTitleorPosition: | PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 5165966100 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.