Eisenman, Mallory Lynn

Eisenman, Mallory Lynn is an sole proprietor health care provider with primary practice located at 1900 Rittenhouse Sq Suite C3, Philadelphia PA 19103-5767. She recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as her primary health care specialty. Eisenman, Mallory Lynn can be contacted via phone (215) 735-3668.

Contact Information

Primary practice address
1900 Rittenhouse Sq Suite C3 Philadelphia PA 19103-5767
Phone: (215) 735-3668
Fax: (215) 735-1838
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X SC0021671 Pennsylvania

Profile Details

NPI number 1487655445
LBN Legal business name Eisenman, Mallory Lynn
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 2nd, 2005
Last updated Mar 11th, 2014 - about 11 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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Identifiers

StateTypeNumberIssuer
All States NPI 1487655445 NPPES
Pennsylvania Other 0480001090 RAILROAD MEDICARE
Pennsylvania Other 000492696 RAILROAD MEDICARE
Pennsylvania Other 402696 RAILROAD MEDICARE
Pennsylvania MEDICAID 010346300001 RAILROAD MEDICARE

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