Audrey L. Eisenstadt, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

150594 Issued in NY

Practice address

369 E Main St
Suite 18
East Islip, NY 11730-2800

Phone

(631) 277-1600

Fax

(631) 277-1638

NPI assigned

Jun 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255478400000",
    "number": "1285660266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "369 E MAIN ST",
            "address_2": "SUITE 18",
            "city": "EAST ISLIP",
            "state": "NY",
            "postal_code": "117302800",
            "telephone_number": "631-277-1600",
            "fax_number": "631-277-1638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "369 E MAIN ST",
            "address_2": "SUITE 18",
            "city": "EAST ISLIP",
            "state": "NY",
            "postal_code": "117302800",
            "telephone_number": "631-277-1600",
            "fax_number": "631-277-1638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENSTADT",
        "first_name": "AUDREY",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2009-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "150594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00893141",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deyon Durante-Fuentes, RN, BSN
• East Islip Pharmacy Inc
• East Islip Physical Therapy and Rehabilitation PC
• East Islip School District
• East Main Street Dental PC
• Alyssa Michele Ercolino
• Exchange Ambulance Corporation of the Islips
• Karen Gail Fagioli, LMSW
• Tzanwei Fang, M.D.
• Michele Loren Farley

• Diagnostic Radiology Physician in East Islip, NY
• Providers in East Islip, NY by specialty
• Diagnostic Radiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2009; 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.