Provider Demographics
NPI:1992990998
Name:BRICKMAN, JILL (PSYD)
Entity type:Individual
Prefix:MRS
First Name:JILL
Middle Name:
Last Name:BRICKMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 EAST 95TH STREET
Mailing Address - Street 2:APT. 19G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128
Mailing Address - Country:US
Mailing Address - Phone:914-949-7699
Mailing Address - Fax:914-949-3224
Practice Address - Street 1:141 N. CENTRAL AVENUE
Practice Address - Street 2:C/O WJCS
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530
Practice Address - Country:US
Practice Address - Phone:914-949-7699
Practice Address - Fax:914-949-3224
Is Sole Proprietor?:No
Enumeration Date:2007-09-12
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018381-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist