Active NPI
Marc Eichenbaum, DR.
- Psychologist
- University Heights, OH
National Provider Identifier
1124933569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 028396
- Practice address
- 4473 Silsby Rd
University Heights, OH 44118-3938 - Phone
- (516) 524-3713
- NPI assigned
- Aug 18, 2026
- Last updated
- Aug 18, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | P.09018 | OH | |
| Psychologist | 103T00000X | 028396 | NY | Primary |
Addresses
Primary practice location
4473 Silsby Rd
University Heights, OH 44118-3938
Mailing address
4473 Silsby Rd
University Heights, OH 44118-3938
Other practice location 1
25 Robert Pitt Dr
Monsey, NY 10952-3365
Phone (845) 425-5252
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P.09018 | OH | MD | Psychologist |
| 028396 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1787011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787011200000",
"number": "1124933569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4473 SILSBY RD",
"city": "UNIVERSITY HEIGHTS",
"state": "OH",
"postal_code": "441183938"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4473 SILSBY RD",
"city": "UNIVERSITY HEIGHTS",
"state": "OH",
"postal_code": "441183938",
"telephone_number": "516-524-3713"
}
],
"practiceLocations": [
{
"address_1": "25 Robert Pitt Dr",
"address_purpose": "LOCATION",
"city": "Monsey",
"state": "NY",
"postal_code": "109523365",
"country_code": "US",
"telephone_number": "845-425-5252",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EICHENBAUM",
"first_name": "MARC",
"credential": "DR.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-08-18",
"last_updated": "2026-08-18",
"certification_date": "2026-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OH",
"license": "P.09018",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "028396",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in University Heights, OH
- Vanessa Dvorin-Fremont, MA, MSSA, LISW-S
- Malka Dym, BCBA
- Lesley Echols-Blakely
- Edu-at-Tech, LLC (Educational Assistive Technology, LLC)
- Latricia Nikia Edwards, C.R.N.P
- Elaya Health Midwest LLC
- Chineze Nwakego Enwonwu, D.M.D.
- Erica M Gaitley DC PA LLC
- Eyes of the World of Ohio Inc. (Lens & Eye Vision Centre)
- F&S Neuromonitoring, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.