Dr Ethan Eisen, PHD - Psychologist in Lawrence, NY

Dr Ethan Eisen, PHD is a Psychologist - Clinical based in Lawrence, New York. Dr Ethan Eisen is licensed to practice in Maryland (license number 05837) and his current practice location is 107 Lakeside Dr E, Lawrence, New York. He can be reached at his office (for appointments etc.) via phone at (516) 259-3148.

NPI number for Dr Ethan Eisen is 1558968842 and his current mailing address is 107 Lakeside Dr E, Lawrence, New York. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1558968842.

Contact Information

Dr Ethan Eisen, PHD
107 Lakeside Dr E,
Lawrence, NY 11559-1718
(516) 259-3148
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameDr Ethan Eisen
GenderMale
SpecialityPsychologist - Clinical
Location107 Lakeside Dr E, Lawrence, New York
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1558968842
  • Provider Enumeration Date: 10/08/2020
  • Last Update Date: 10/08/2020

Medical Identifiers

Medical identifiers for Dr Ethan Eisen such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1558968842NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103TC0700XPsychologist - Clinical 05837 (Maryland)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Ethan Eisen is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Ethan Eisen, PHD
107 Lakeside Dr E,
Lawrence, NY 11559-1718

Ph: (516) 259-3148
Dr Ethan Eisen, PHD
107 Lakeside Dr E,
Lawrence, NY 11559-1718

Ph: (516) 259-3148

Reviews and Comments


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