| Doctor Name: | DR. HENRY M. EISENBERG |
| NPI Number: | 1396941951 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 092148-1 |
| Business Practice Address: | 109 Gadwall Ln Manlius, NY - 131049395 |
| Business Phone Number: | 3156820055 |
| Business Fax Number: | 3156820056 |
| Mailing Address: | 109 Gadwall Ln, MANLIUS |
| State: | NY |
| Postal Code: | 131049395 |
| Phone Number: | 3156820055 |
| Fax Number: | 3156820056 |
| NPI Enumeration Date: | 06/21/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207QA0505X |
| License Number: | 092148-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Family Medicine |
| Taxonomy Specialization: | Adult Medicine |
| Taxonomy Definition: | |