Individual
JODIE EISNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
7559 263RD ST, GLEN OAKS, NY 11004-1150
(718) 470-8624
Mailing address
7559 263RD ST, GLEN OAKS, NY 11004-1150
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
021249
NY
Other
Enumeration date
08/03/2015
Last updated
08/03/2015
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