Provider Demographics
NPI:1750752473
Name:EISENHEIM, JESSICA NITYA (ND)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:NITYA
Last Name:EISENHEIM
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 FEDERAL ST STE 1
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01301-5201
Mailing Address - Country:US
Mailing Address - Phone:413-676-9009
Mailing Address - Fax:
Practice Address - Street 1:70 FEDERAL ST STE 1
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-5201
Practice Address - Country:US
Practice Address - Phone:413-676-9009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-08
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT099.0115051175F00000X
MAND0026175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath