Organization Active NPI

Howard M. Eisenstodt, M.D., P.a.

  • Ophthalmology Physician
  • Millburn, NJ
National Provider Identifier
1083944607
Registry record updated Sep 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
25MA01690200 Issued in NJ
Legal business name
HOWARD M. EISENSTODT, M.D., P.A.
Practice address
75 Main St.
Suite 207
Millburn, NJ 07041-1322
Phone
(973) 376-6400
Fax
(973) 376-0797
NPI assigned
Jan 4, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Howard M. Eisenstodt, M.D.
Title
President
Phone
(973) 376-6400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 25MA01690200 NJ Primary

Addresses

Primary practice location

75 Main St.
Suite 207
Millburn, NJ 07041-1322

Mailing address

75 Main St.
Suite 207
Millburn, NJ 07041-1322
Phone (973) 376-6400

Other identifiers 1

IdentifierTypeStateIssuer
2768402MedicaidNJ

National Provider Directory

National Provider Directory

Locations

75 Main St
Ste 207
Millburn, NJ 07041
Phone (973) 376-6400

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1262563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348012800000",
    "number": "1083944607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 MAIN ST.",
            "address_2": "SUITE 207",
            "city": "MILLBURN",
            "state": "NJ",
            "postal_code": "070411322",
            "telephone_number": "973-376-6400",
            "fax_number": "973-376-0797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 MAIN ST.",
            "address_2": "SUITE 207",
            "city": "MILLBURN",
            "state": "NJ",
            "postal_code": "070411322",
            "telephone_number": "973-376-6400",
            "fax_number": "973-376-0797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOWARD M. EISENSTODT, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-04",
        "last_updated": "2012-09-19",
        "status": "A",
        "authorized_official_last_name": "EISENSTODT",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-376-6400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NJ",
            "license": "25MA01690200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2768402",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Millburn, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.