Provider Demographics
NPI:1659635936
Name:VOSS, JAY (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:
Last Name:VOSS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:WILLIAM
Other - Middle Name:JAY
Other - Last Name:VOSS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:760 BROADWAY DEPARTMENT OF MANAGED CARE ROOM 2B230
Mailing Address - Street 2:WOODHULL MEDICAL AND MENTAL HEALTH CENTER.
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206
Mailing Address - Country:US
Mailing Address - Phone:718-963-8000
Mailing Address - Fax:718-630-3122
Practice Address - Street 1:760 BROADWAY
Practice Address - Street 2:WOODHULL MEDICAL AND MENTAL HEALTH CENTER
Practice Address - City:BROADWAY
Practice Address - State:NY
Practice Address - Zip Code:11206
Practice Address - Country:US
Practice Address - Phone:718-963-8000
Practice Address - Fax:718-630-3122
Is Sole Proprietor?:No
Enumeration Date:2012-07-01
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015753-1103TC0700X
NJ35S100393700103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical