Provider Demographics
NPI:1841499597
Name:WILKIE, JANET MACPHERSON (PHD)
Entity type:Individual
Prefix:DR
First Name:JANET
Middle Name:MACPHERSON
Last Name:WILKIE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MISS
Other - First Name:JANET
Other - Middle Name:MACPHERSON
Other - Last Name:KAUFFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 812
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-0812
Mailing Address - Country:US
Mailing Address - Phone:845-294-3250
Mailing Address - Fax:845-294-7279
Practice Address - Street 1:11 WEBSTER AVENUE
Practice Address - Street 2:SUITE 9
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924
Practice Address - Country:US
Practice Address - Phone:845-294-3250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008495103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV44282Medicare ID - Type Unspecified