Jill Rosenbaum, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

003589 Issued in CT

Practice address

1 Blachley Rd
2ND Floor
Stamford, CT 06902

Phone

(203) 276-8479

Fax

(203) 276-2282

NPI assigned

Jul 17, 2014

Last updated

May 5, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other names 1

• Jill Rosenbaum Walker Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1405555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1891102299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BLACHLEY RD",
            "address_2": "2ND FLOOR",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "06902",
            "telephone_number": "203-276-8479",
            "fax_number": "203-276-2282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BLACHLEY RD",
            "address_2": "2ND FLOOR",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "06902",
            "telephone_number": "203-276-8479",
            "fax_number": "203-276-2282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "635 W 165th St",
            "address_2": "Room EI-635",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100323724",
            "country_code": "US",
            "telephone_number": "646-317-1151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSENBAUM",
        "first_name": "JILL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-17",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "021612",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CT",
            "license": "003589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "WALKER",
            "middle_name": "ROSENBAUM",
            "credential": "PH.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Monica Angel Rosado, LCSW
• Francheska M Rosario
• Yuliza Rosas, B.S
• Rose Psychiatry PLLC
• Raphael Judah Rosen, M.D.
• Julie Rosenberg, MS, CCC-SLP
• Larry M Rosenberg, PH.D.
• Remi Rosenberg, MD
• Jon Charles Rosenblitt, D.M.D.
• Sylvie Rosenbloom, APRN, FNP-BC, CDE

• Psychologist in Stamford, CT
• Providers in Stamford, CT by specialty
• Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.