Laura Ann Eisdorfer, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

35SI00301600 Issued in NJ

Practice address

830 Garrison Ave
Teaneck, NJ 07666-2542

Phone

(201) 801-0115

NPI assigned

Jan 19, 2007

Sex

Female

Sole proprietor

Yes

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2017 through Jan 1, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1518010073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 GARRISON AVE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076662542",
            "telephone_number": "201-801-0115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 GARRISON AVE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076662542",
            "telephone_number": "201-801-0115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISDORFER",
        "first_name": "LAURA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00301600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002830401",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Margaret Denise Edwards, ANP
• Andrea Egert, LCSW
• David Saul Ehrenberg, DDS, MS
• Rachel Ehrenberg
• Gerard T Eichman, M.D.
• Khaya Eisenberg, PSY.D.
• Daniel Marc Eisman, M.D.
• Ejaj LLC (The Lazar Center)
• Ejlh Counseling Services LLC
• Odera Ekwunife, PHARMD, RPH

• Clinical Psychologist in Teaneck, NJ
• Providers in Teaneck, NJ by specialty
• Clinical Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.