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Individual

DR. LAWRENCE B EISENBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1201 NOTT ST, SUITE 106, SCHENECTADY, NY 12308-2589
(518) 374-3123
(518) 374-9711
Mailing address
1201 NOTT ST, SUITE 106, SCHENECTADY, NY 12308-2589
(518) 374-3123
(518) 374-9711

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
104055-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000091607
GHI HMO
01
000410990001
BLUE SHIELD NENY
01
000410990003
BLUE SHIELD NENY
05
00392856
NY
01
040426006662
FIDELIS
01
05105
MVP
01
10000562
CDPHP
01
104055-1
TRICARE NORTH REGION
01
110160500
US DEPT OF LABOR
01
28481
EMPIRE BLUE CROSS
01
33570J
FIDELIS MEDICARE
01
9711439
GHI
01
CAN1040559
NO FAULT
01
D01977
AMERICAN PROGRESSIVE TODA
01
LE02848110
EMPIRE BLUE CROSS
01
LE02848120
EMPIRE BLUE CROSS
Enumeration date
08/09/2005
Last updated
11/11/2010
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