Provider Demographics
NPI: | 1528181724 |
---|---|
Name: | BELLINSON, JILL (PHD) |
Entity Type: | Individual |
Prefix: | DR |
First Name: | JILL |
Middle Name: | |
Last Name: | BELLINSON |
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: | 229 W 71ST ST |
Mailing Address - Street 2: | |
Mailing Address - City: | NEW YORK |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 10023-3704 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 212-724-6266 |
Mailing Address - Fax: | 212-874-6177 |
Practice Address - Street 1: | 229 W 71ST ST |
Practice Address - Street 2: | |
Practice Address - City: | NEW YORK |
Practice Address - State: | NY |
Practice Address - Zip Code: | 10023-3704 |
Practice Address - Country: | US |
Practice Address - Phone: | 212-724-6266 |
Practice Address - Fax: | 212-874-6177 |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2007-04-10 |
Last Update Date: | 2007-07-08 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NY | PSY007206 | 103TC0700X, 103TC2200X, 103TP0814X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Not Answered | 103TC0700X | Behavioral Health & Social Service Providers | Psychologist | Clinical |
Not Answered | 103TC2200X | Behavioral Health & Social Service Providers | Psychologist | Clinical Child & Adolescent |
Not Answered | 103TP0814X | Behavioral Health & Social Service Providers | Psychologist | Psychoanalysis |