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:DR
Other - First Name:JODI
Other - Middle Name:ELENE
Other - Last Name:ROSENTHAL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD/PHD
Mailing Address - Street 1:57 BEDFORD ST STE 230
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02420-4502
Mailing Address - Country:US
Mailing Address - Phone:781-226-2959
Mailing Address - Fax:570-243-0810
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:
Is Sole Proprietor?:No
Enumeration Date:2013-03-20
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2666602084P0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry