Active NPI
Jill Brook, PHD
- Clinical Neuropsychologist
- Gladstone, NJ
National Provider Identifier
1881909224
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 35SI00290300
- Practice address
- 205 Main St
Gladstone, NJ 07934-2059 - Phone
- (908) 719-7555
- Fax
- (908) 719-7523
- NPI assigned
- Aug 10, 2010
- Last updated
- Aug 10, 2010
- Sex
- Female
- Sole proprietor
- No
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 Neuropsychologist | 103G00000X | 35SI00290300 | NJ | Primary |
Addresses
Primary practice location
205 Main St
Gladstone, NJ 07934-2059
Mailing address
PO Box 542
Gladstone, NJ 07934-0542
Phone (908) 719-7555
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35SI00290300 | NJ | MD | Clinical Neuropsychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1281398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281398400000",
"number": "1881909224",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 542",
"city": "GLADSTONE",
"state": "NJ",
"postal_code": "079340542",
"telephone_number": "908-719-7555",
"fax_number": "908-719-7523"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 MAIN ST",
"city": "GLADSTONE",
"state": "NJ",
"postal_code": "079342059",
"telephone_number": "908-719-7555",
"fax_number": "908-719-7523"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOK",
"first_name": "JILL",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-10",
"last_updated": "2010-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "NJ",
"license": "35SI00290300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gladstone, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.