| NPI | 1578940219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN EISENSTOCK President Owner 508-898-0055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Additional Taxonomies | 103T00000X Psychologist |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 231108) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2015-05-01 |
| Last Update Date | 2021-05-20 |