Individual
KHAYA EISENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
696 PALISADE AVE, TEANECK, NJ 07666-3144
(201) 692-3972
Mailing address
259 BROOK AVE, PASSAIC, NJ 07055-3311
(347) 404-3334
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
TP# 113-088
NJ
Other
Enumeration date
02/07/2012
Last updated
02/07/2012
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