Provider Demographics
NPI:1871793489
Name:EISENBERGER, MARC (DC)
Entity type:Individual
Prefix:
First Name:MARC
Middle Name:
Last Name:EISENBERGER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 GRACE RD
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-2752
Mailing Address - Country:US
Mailing Address - Phone:732-651-8745
Mailing Address - Fax:732-651-8746
Practice Address - Street 1:1510 CORLIES AVE
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-4904
Practice Address - Country:US
Practice Address - Phone:732-775-1826
Practice Address - Fax:732-775-1827
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-21
Last Update Date:2007-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC00491000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor