Provider Demographics
NPI:1285245720
Name:PADAWER, JILL ANNE (PHD)
Entity type:Individual
Prefix:DR
First Name:JILL
Middle Name:ANNE
Last Name:PADAWER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 86
Mailing Address - Street 2:
Mailing Address - City:HASTINGS ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10706-0086
Mailing Address - Country:US
Mailing Address - Phone:617-835-9949
Mailing Address - Fax:
Practice Address - Street 1:80 LEXINGTON DR # 2
Practice Address - Street 2:
Practice Address - City:CROTON ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:10520-2825
Practice Address - Country:US
Practice Address - Phone:617-835-9949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-10
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4872-PY-PR103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical