Doctor Name: | JILLIAN EISENBRAUN |
NPI Number: | 1073942843 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.A. C |
License Number: | 25MP00295400 |
Business Practice Address: | 670 N Beers St Bldg 4 Unit 2 Holmdel, NJ - 077331516 |
Business Phone Number: | 7323353434 |
Business Fax Number: | |
Mailing Address: | 46 Woodbine Ave, LITTLE SILVER |
State: | NJ |
Postal Code: | 077391313 |
Phone Number: | 7327471420 |
Fax Number: | |
NPI Enumeration Date: | 11/02/2013 |
NPI Last Update Date: | 11/02/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 25MP00295400 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |