Individual
SIDNEY BERNARD EISIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
630 W 168TH ST, SUITE VC7-226, NEW YORK, NY 10032-3725
(212) 305-4552
(212) 305-9649
Mailing address
180 FORT WASHINGTON AVE, SUITE HP8-802, NEW YORK, NY 10032-3735
(212) 305-8516
(212) 305-9017
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
036028
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00964356
—
NY
01
—
0348187
CIGNA
NY
01
—
036028N02
HIP
NY
01
—
1300099
GHI
NY
01
—
2635591
AETNA HMO
NY
01
—
4309559
AETNA PPO
NY
01
—
45913P
HIP MEDICAID
NY
01
—
4C1608
HEALTHNET PHS
NY
01
—
683721
UNITED HEALTHCARE
NY
01
—
D48781
EMPIRE BCBS
NY
01
—
GS361
OXFORD
NY
Enumeration date
01/03/2007
Last updated
07/08/2007
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