Organization
YAKOV EISENBERGER DDS; MSD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PATRICIA M GAHLES RDH (MANAGER)
(718) 622-2695
Entity
Organization
Contact information
Practice address
1 HANSON PL STE 1308, BROOKLYN, NY 11243-2902
(718) 622-2695
Mailing address
125 RAND PL, LAWRENCE, NY 11559-1326
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
046884
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02165171
—
NY
Enumeration date
08/05/2006
Last updated
08/22/2020
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