Teddi F Eisen, M.D.

Primary specialty

Occupational Medicine PhysicianTaxonomy code 2083X0100X

License

MD049135L Issued in PA

Practice address

505 Waters Edge
Newtown Square, PA 19073-2130

Phone

(215) 861-4119

Fax

(215) 861-4121

NPI assigned

Feb 2, 2007

Last updated

Sep 30, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380499200000",
    "number": "1114065919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 WATERS EDGE",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190732130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 WATERS EDGE",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190732130",
            "telephone_number": "215-861-4119",
            "fax_number": "215-861-4121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISEN",
        "first_name": "TEDDI",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2013-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "MA",
            "license": "55511",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "PA",
            "license": "MD049135L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Medicine Physician in Newtown Square, PA
• Providers in Newtown Square, PA by specialty
• Occupational Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2013; 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.