| Daniel Eisenman Llc | |
|
11030 Jones Bridge Rd Suite 203 Johns Creek GA 30022-4560 | |
| (678) 263-8512 | |
| (678) 298-9997 |
| Full Name | Daniel Eisenman Llc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 11030 Jones Bridge Rd, Johns Creek, Georgia |
| Authorized Official Name and Position | Daniel D Eisenman (OWNER) |
| Authorized Official Contact | 6782638512 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Daniel Eisenman Llc 11030 Jones Bridge Rd Suite 203 Johns Creek GA 30022-4560 Ph: (678) 263-8512 | Daniel Eisenman Llc 11030 Jones Bridge Rd Suite 203 Johns Creek GA 30022-4560 Ph: (678) 263-8512 |
| NPI Number | 1891073797 |
|---|---|
| Provider Enumeration Date | 07/26/2011 |
| Last Update Date | 11/10/2015 |
| Medicare PECOS PAC ID | 7618146614 |
|---|---|
| Medicare Enrollment ID | O20110809000237 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891073797 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | PSY003084 (Georgia) | Primary |
| Provider Name | Daniel D Eisenman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1376757856 PECOS PAC ID: 4385734177 Enrollment ID: I20071217000615 |
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