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Contact Information

JACOB EISDORFER, DDS
1162 42ND ST
BROOKLYN, NY11219-1213
 Phone: 347-209-7158
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist Anesthesiologist

1223D0004X
 

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for JACOB EISDORFER · (Male)

NPI Number 1881919728
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 04/04/2010
Last updated 03/24/2015 - About 11 years ago
Sole proprietor 1 Yes
Identifiers
  • NJ License # 22DI02480400
  • NY License # 00055621
  • NY Medicaid 03355406
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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