Provider Demographics
NPI:1063444164
Name:ALBERTS, JILL VORENBERG (PSYD, LCSW,MPH)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:VORENBERG
Last Name:ALBERTS
Suffix:
Gender:F
Credentials:PSYD, LCSW,MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 E 93RD ST
Mailing Address - Street 2:APT. 2A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-0626
Mailing Address - Country:US
Mailing Address - Phone:212-876-7290
Mailing Address - Fax:
Practice Address - Street 1:55 E 92ND ST
Practice Address - Street 2:1-A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1300
Practice Address - Country:US
Practice Address - Phone:212-828-5757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016632-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP3667273OtherOXFORD HEALTH PLANS
NYP3667273OtherOXFORD HEALTH PLANS