Individual
DR. THEODORE E EISENSTAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3900 PARK AVE, SUITE 101, EDISON, NJ 08820-3032
(732) 494-6640
(732) 549-8204
Mailing address
3900 PARK AVE, SUITE 101, EDISON, NJ 08820-3032
(732) 494-6640
(732) 549-8204
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
25MA02494100
NJ
208C00000X
Colon & Rectal Surgery Physician
Primary
25MA024994100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1595008
—
NJ
Enumeration date
01/30/2006
Last updated
04/11/2024
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