Eisenberg, Staci R
Eisenberg, Staci R is an individual health care provider with primary practice located at 1153 Centre St , Jamaica Plain MA 02130-3446. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Eisenberg, Staci R can be contacted via phone (617) 983-7025.Contact Information
Primary practice address
1153 Centre St
Jamaica Plain MA 02130-3446
Phone: (617) 983-7025
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD15098 | Rhode Island |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 220587 | Massachusetts |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | MD15098 | Rhode Island |
Profile Details
| NPI number | 1033109301 |
|---|---|
| LBN Legal business name | Eisenberg, Staci R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 26th, 2005 |
| Last updated | Feb 7th, 2019 - about 6 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 | 1033109301 | NPPES |
| Rhode Island | Other | MD15098 | LICENSE |
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