Gary M. Eisenberg, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY2170 Issued in FL

Practice address

950 Glades Rd
Suite 1-a
Boca Raton, FL 33431-6401

Phone

(561) 392-1414

Fax

(561) 391-2722

NPI assigned

Dec 6, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291161600000",
    "number": "1194884304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 GLADES RD",
            "address_2": "SUITE 1-A",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316401",
            "telephone_number": "561-392-1414",
            "fax_number": "561-391-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 GLADES RD",
            "address_2": "SUITE 1-A",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316401",
            "telephone_number": "561-392-1414",
            "fax_number": "561-391-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENBERG",
        "first_name": "GARY",
        "middle_name": "M.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2010-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY2170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Elisabeth Eichler, M.D.
• Tarek Ismail Eid, MD
• Bruce N Eimer, PH.D.
• Howard M Eimer, RPH, CPH
• Eirny Medical LLC
• Randi Eisenberg
• Robert J Eisenberg, DDS
• Stephanie Shoshana Eisenberger, LCSW
• P H Eisenfeld, D.P.M.
• Daniella Eisenstein

• Clinical Psychologist in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2010; 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.