| Doctor Name: | DR. MICHAEL B EBERLIN |
| NPI Number: | 1588648919 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | 0985434392 |
| Business Practice Address: | 71 W Main St Suite 1 Oyster Bay, NY - 117712258 |
| Business Phone Number: | 5165587490 |
| Business Fax Number: | 8772056740 |
| Mailing Address: | 71 W Main St, Suite 1 OYSTER BAY |
| State: | NY |
| Postal Code: | 117712258 |
| Phone Number: | 5165587490 |
| Fax Number: | 8772056740 |
| NPI Enumeration Date: | 11/30/2005 |
| NPI Last Update Date: | 09/24/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TS0200X |
| License Number: | 0985434392 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |