Provider Demographics
NPI:1184461824
Name:BORKAN, JESSIE (PSYD)
Entity type:Individual
Prefix:
First Name:JESSIE
Middle Name:
Last Name:BORKAN
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 1:6 E 39TH ST STE 800
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-0037
Mailing Address - Country:US
Mailing Address - Phone:347-541-4404
Mailing Address - Fax:
Practice Address - Street 1:6 E 39TH ST STE 800
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-0037
Practice Address - Country:US
Practice Address - Phone:347-541-4404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026563103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical