Provider Demographics
NPI:1720320401
Name:EIPPER-MAINS, JODI ELENE (MD/PHD)
Entity Type:Individual
Prefix:DR
First Name:JODI
Middle Name:ELENE
Last Name:EIPPER-MAINS
Suffix:
Gender:F
Credentials:MD/PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:281 WINTER ST STE 340
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-8760
Mailing Address - Country:US
Mailing Address - Phone:781-646-0500
Mailing Address - Fax:570-243-0810
Practice Address - Street 1:281 WINTER ST STE 340
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-8760
Practice Address - Country:US
Practice Address - Phone:781-336-5040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-20
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2666602084P0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry