Individual
MR. RICHARD M EISENBERG
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
25 OAK AVE, WORCESTER, MA 01605-2751
(508) 421-2010
(508) 756-8078
Mailing address
25 OAK AVE, WORCESTER, MA 01605-2751
(508) 421-2010
(508) 756-8078
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
59690
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3035123
—
MA
01
—
J07475
BLUE SHIELD
MA
Enumeration date
05/10/2006
Last updated
07/08/2007
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