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Individual

DR. AUDREY L. EISENSTADT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
369 E MAIN ST, SUITE 18, EAST ISLIP, NY 11730-2800
(631) 277-1600
(631) 277-1638
Mailing address
369 E MAIN ST, SUITE 18, EAST ISLIP, NY 11730-2800
(631) 277-1600
(631) 277-1638

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
150594
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00893141
NY
Enumeration date
06/23/2006
Last updated
10/14/2009
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