Active NPI
Jill Bowen
- Clinical Psychologist
- Brooklyn, NY
National Provider Identifier
1184707341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 009664
- Practice address
- 451 Clarkson Ave
Brooklyn, NY 11203-2057 - Phone
- (718) 245-2306
- NPI assigned
- Oct 23, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 009664 | NY | Primary |
Addresses
Primary practice location
451 Clarkson Ave
Brooklyn, NY 11203-2057
Mailing address
1423 Sturl Ave
Hewlett, NY 11557-1424
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009664 | NY | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184707341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1423 STURL AVE",
"city": "HEWLETT",
"state": "NY",
"postal_code": "115571424"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "451 CLARKSON AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112032057",
"telephone_number": "718-245-2306"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOWEN",
"first_name": "JILL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "009664",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.