Provider Demographics
NPI:1740091164
Name:EIPPER-MAINS PSYCHIATRIC
Entity type:Organization
Organization Name:EIPPER-MAINS PSYCHIATRIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JODI
Authorized Official - Middle Name:ELENE
Authorized Official - Last Name:EIPPER-MAINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:781-226-2959
Mailing Address - Street 1:8 OVERLOOK DR
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01730-1331
Mailing Address - Country:US
Mailing Address - Phone:617-874-7994
Mailing Address - Fax:
Practice Address - Street 1:57 BEDFORD ST STE 230
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02420-4502
Practice Address - Country:US
Practice Address - Phone:781-226-2959
Practice Address - Fax:570-243-0810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty