Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 024081 | NY |
Y | 103T00000X | Psychologist | 024081 | NY |
NPI | 1003585142 |
---|---|
Provider Name | Dr. Jamie Eiseman |
First Address | Great Neck, NY 11021-2205 |
Second Address | Roslyn, NY 11576-1506 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2021 |
Last Update Date | 11/09/2021 |