Most Relevant Information
Provider Data
| NPI Number: | 1003585142 |
| Provider Name: | JAMIE EISEMAN PSY.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 103T00000X |
| Specialty: | Psychologist |
| License Number: | 024081 |
Most Important Dates
| Enumeration Date: | 09/11/2021 |
| Last Updated: | 09/11/2021 |
Provider Practice Location
1025 NORTHERN BLVD STE 95
ROSLYN
NY
115761506
Practice Location Phone/Fax
| Phone: | 9178174004 |
| Fax: |
Provider Mailing Location
21 BARSTOW RD APT 2I
GREAT NECK
NY
110212205
Provider Mailing Phone/Fax
| Phone: | 5165784245 |
| Fax: |