| Jill Thistlethwaite, Phd | |
|
156 5th Ave Suite 720 New York NY 10010-7002 | |
| (212) 337-9596 | |
| Not Available |
| Full Name | Jill Thistlethwaite, Phd |
|---|---|
| Speciality | Psychologist |
| Location | 156 5th Ave, New York, New York |
| Authorized Official Name and Position | Jill Thistlethwaite (PRESIDENT) |
| Authorized Official Contact | 2129825247 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jill Thistlethwaite, Phd 144 E 7th St Suite C-12 New York NY 10009-6203 Ph: (212) 982-5247 | Jill Thistlethwaite, Phd 156 5th Ave Suite 720 New York NY 10010-7002 Ph: (212) 337-9596 |
| NPI Number | 1063600047 |
|---|---|
| Provider Enumeration Date | 10/04/2007 |
| Last Update Date | 10/04/2007 |
| Medicare PECOS PAC ID | 0042393563 |
|---|---|
| Medicare Enrollment ID | O20080207000104 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063600047 | NPI | - | NPPES |
| 01132934 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 007451 (New York) | Primary |
| Provider Name | Jill Thistlethwaite |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1407911902 PECOS PAC ID: 4789579376 Enrollment ID: I20040223000004 |
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