Eisen, Ethan

Eisen, Ethan is an sole proprietor health care provider with primary practice located at 107 Lakeside Dr E , Lawrence NY 11559-1718. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Eisen, Ethan can be contacted via phone (516) 259-3148.

Contact Information

Primary practice address
107 Lakeside Dr E Lawrence NY 11559-1718
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 05837 Maryland

Profile Details

NPI number 1558968842
LBN Legal business name Eisen, Ethan
Credentials PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 8th, 2020
Last updated Oct 8th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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