Basic Information
| Provider Information | |||||||||
| NPI: | 1992990998 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BRICKMAN | ||||||||
| FirstName: | JILL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | PSYD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 182 EAST 95TH STREET | ||||||||
| Address2: | APT. 19G | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10128 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9149497699 | ||||||||
| FaxNumber: | 9149493224 | ||||||||
| Practice Location | |||||||||
| Address1: | 141 N. CENTRAL AVENUE | ||||||||
| Address2: | C/O WJCS | ||||||||
| City: | HARTSDALE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10530 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9149497699 | ||||||||
| FaxNumber: | 9149493224 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/12/2007 | ||||||||
| LastUpdateDate: | 11/23/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | 018381-1 | NY | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.