Individual
DR. MALLORY LYNN EISENMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
1900 RITTENHOUSE SQ, SUITE C3, PHILADELPHIA, PA 19103-5767
(215) 735-3668
(215) 735-1838
Mailing address
1900 RITTENHOUSE SQ, SUITE C3, PHILADELPHIA, PA 19103-5767
(215) 735-3668
(215) 735-1838
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC0021671
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000492696
BLUECROSS
—
05
—
010346300001
—
PA
01
—
0480001090
RAILROAD MEDICARE
PA
01
—
402696
HIGHMARK
—
Enumeration date
08/02/2005
Last updated
03/11/2014
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