Provider Demographics
NPI:1538257100
Name:EISEN FAMILY CHIROPRACTIC CENTER, P.C.
Entity type:Organization
Organization Name:EISEN FAMILY CHIROPRACTIC CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:EISEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-261-3600
Mailing Address - Street 1:44 E QUACKENBUSH AVE
Mailing Address - Street 2:
Mailing Address - City:DUMONT
Mailing Address - State:NJ
Mailing Address - Zip Code:07628-3006
Mailing Address - Country:US
Mailing Address - Phone:201-261-3600
Mailing Address - Fax:201-261-3630
Practice Address - Street 1:299 FOREST AVE
Practice Address - Street 2:SUITE Q
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-5424
Practice Address - Country:US
Practice Address - Phone:201-261-3600
Practice Address - Fax:201-261-3630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0093564Medicaid
NJ096417Medicare PIN