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1558968842
ETHAN EISEN
LAWRENCE, NY
NPI
1558968842
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: MD 05837)
Enumeration Date
2020-10-08
Last Update Date
2020-10-08
Business Address
Dr. ETHAN EISEN PhD
107 LAKESIDE DR E
LAWRENCE, NY 11559-1718
Phone number: 516-259-3148
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Mailing Address
Dr. ETHAN EISEN PhD
107 LAKESIDE DR E
LAWRENCE, NY 11559-1718
Phone number: 516-259-3148
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