Eisenberg, Phyllis Terry
Eisenberg, Phyllis Terry is an sole proprietor health care provider with primary practice located at 250 N Sunny Slope Rd Suite 290, Brookfield WI 53005-4809. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Nursing Service Providers / Psychiatric/Mental Health, Child & Adolescent. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Eisenberg, Phyllis Terry can be contacted via phone (262) 754-9460.Contact Information
Primary practice address
250 N Sunny Slope Rd Suite 290
Brookfield WI 53005-4809
Phone: (262) 754-9460
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 1884-125 | Wisconsin |
| Nursing Service Providers / Psychiatric/Mental Health, Child & Adolescent | 163WP0807X | 51189-030 | Wisconsin |
Profile Details
| NPI number | 1730236977 |
|---|---|
| LBN Legal business name | Eisenberg, Phyllis Terry |
| Credentials | BS RN, MEED |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 3rd, 2007 |
| Last updated | Sep 26th, 2008 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1730236977 | NPPES |
| Wisconsin | MEDICAID | 39790000 |
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