Individual
MR. MICHAEL VINCENT EISENBRAUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
475 SEAVIEW AVE, STATEN ISLAND, NY 10305-3436
(718) 226-9508
Mailing address
142 HAWTHORNE AVE, STATEN ISLAND, NY 10314-1815
(718) 761-0294
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
23009070
NY
Other
Enumeration date
05/04/2011
Last updated
05/04/2011
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