Provider Demographics
NPI:1467961037
Name:ISENSTADT, JENNIFER SERENE (PS:MH)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:SERENE
Last Name:ISENSTADT
Suffix:
Gender:F
Credentials:PS:MH
Other - Prefix:
Other - First Name:JOSHUA
Other - Middle Name:STEVEN
Other - Last Name:ISENSTADT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3770 N HIGH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3525
Mailing Address - Country:US
Mailing Address - Phone:614-290-2291
Mailing Address - Fax:614-294-7443
Practice Address - Street 1:3770 N HIGH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3525
Practice Address - Country:US
Practice Address - Phone:614-290-2291
Practice Address - Fax:614-294-7443
Is Sole Proprietor?:No
Enumeration Date:2017-09-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist