DR. ETHAN EISEN (NPI# 1558968842) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558968842 |
| Entity Type | Individual |
| Full Name | DR. ETHAN EISEN |
| Credential | PHD |
| Practice Address |
107 Lakeside Dr E Lawrence NY 11559-1718 |
| Practice Telephone | 5162593148 |
| Mailing Telephone | 5162593148 |
| Enumeration Date | 2020-10-08 |
| Last Update Date | 2020-10-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
05837 | MD | Behavioral Health & Social Service Providers |
| Street Address |
107 LAKESIDE DR E |
| City | LAWRENCE |
| State | NY |
| Zip Code | 11559-1718 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306310362 | Marlee Katz | Specialist | 26 Sealy Dr, Lawrence, NY 11559 | 2019-01-13 |
| 1184000374 | Rebecca Beiss | Speech-Language Pathologist | 40 Stevens Place, Lawrence, NY 11559 | 2015-08-11 |
| 1114268620 | Gegendeep Kaur Chawla | Occupational Therapist | 219 Spring St, Lawrence, NY 11559 | 2013-03-07 |
| 1972872810 | Esther P Adler | Occupational Therapist | 227 Juniper Cir S, Lawrence, NY 11559 | 2011-12-21 |
| 1790068229 | Elisheva Listhaus | Speech-Language Pathologist | 70 Causeway, Lawrence, NY 11559 | 2011-09-21 |
| 1073803367 | Michele Golub Seelenfreund | Occupational Therapist | 15 Sealy Drive, Lawrence, NY 11559 | 2011-04-08 |
| 1306153804 | Benjamin Z. Weiss | Psychologist | 360 Central Avenue-suite 110, Suite 110, Lawrence, NY 11559 | 2010-09-03 |
| 1497900203 | Sharon Miriam Moerman | Speech-Language Pathologist | 240 Juniper Circle East, Lawrence, NY 11559 | 2008-11-20 |
| 1134376569 | Shifra Eisig | Dietitian, Registered | 43 Herrick Drive, Lawrence, NY 11559 | 2008-08-27 |
| 1710102306 | Mark Billet | Dentist | 290 Central Avenue, 208, Lawrence, NY 11559 | 2007-04-17 |
| Find all providers in zip 11559 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750914321 | Brian Patrick Russell | Psychologist | 730 New Hampshire St Ste 3m, Lawrence, KS 66044-3174 | 2020-02-21 |
| 1528300183 | Jessica Modrell | Psychologist | 719 Massachusetts St Ste 122, Lawrence, KS 66044-2345 | 2013-03-21 |
| 1689945669 | Alan Winder Psychological Services PC | Psychologist | 7 Sterling Pl, Lawrence, NY 11559-2414 | 2012-01-23 |
| 1205064953 | Patrick James Nicholas | Psychologist | 1035 Vermont St, Suite C, Lawrence, KS 66044-2921 | 2009-07-01 |
| 1124143060 | Robert Wray Barnett | Psychologist | 922 E 1100 Rd, Lawrence, KS 66047-9425 | 2007-03-20 |
| 1861578577 | Joy K Rannebeck | Psychologist | 3109 W 27th St, Lawrence, KS 66047-3207 | 2006-10-27 |
| 1942396825 | Elton M Squyres | Psychologist | 1017 Kentucky Street, Lawrence, KS 66044 | 2006-10-05 |
| 1407954555 | Pamela J. Botts | Psychologist | 719 Massachusetts, Lawrence, KS 66044 | 2006-09-20 |
| 1134144538 | Jerry Lyons | Psychologist | 2523 Knox Dr, Lawrence, KS 66046-5636 | 2006-07-13 |
| 1801827183 | Sarah Beth Kirk | Psychologist | 1415 Jayhawk Blvd, Ku Psychological Clinic, Fraser Hall, Lawrence, KS 66045-7556 | 2006-07-05 |
| Find all providers in LAWRENCE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.