Individual
ERIC J NISENBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
460 W 10TH AVE FL 5, COLUMBUS, OH 43210-1240
(614) 293-8074
(614) 293-3193
Mailing address
700 ACKERMAN RD STE 2120, COLUMBUS, OH 43202-1559
(614) 293-8074
(614) 293-3193
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
35.150312
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/20/2018
Last updated
05/20/2024
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