DR. Ethan Eisen, PHD

NPI #1558968842 in Lawrence, New York

Provider Information

NPI Number
1558968842
Entity Type
Individual
Name
DR. Ethan Eisen, PHD
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Psychologist - Clinical
Credential
PHD
Enumeration Date
Oct 8, 2020
Last Updated
Oct 8, 2020

Practice Location

Address
107 LAKESIDE DR E
ZIP Code
11559-1718
Phone
(516) 259-3148

Specialties & Taxonomy Codes

Specialty
Psychologist - ClinicalClinical

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