Active NPI
Gloria Yrizarry Tillmann, PHD
- Psychologist
- Colts Neck, NJ
National Provider Identifier
1891961744
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- NJ1720
- Practice address
- 14 Red Hawk Rd No
Colts Neck, NJ 07722 - Phone
- (732) 946-3648
- NPI assigned
- May 1, 2008
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | NJ1720 | NJ | Primary |
Addresses
Primary practice location
14 Red Hawk Rd No
Colts Neck, NJ 07722
Mailing address
14 Red Hawk Rd No
Colts Neck, NJ 07722
Phone (732) 946-3648
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720 | Other | NJ LICENSE |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NJ1720 | NJ | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209600000000",
"number": "1891961744",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 RED HAWK RD NO",
"city": "COLTS NECK",
"state": "NJ",
"postal_code": "07722",
"telephone_number": "732-946-3648"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14 RED HAWK RD NO",
"city": "COLTS NECK",
"state": "NJ",
"postal_code": "07722",
"telephone_number": "732-946-3648"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TILLMANN",
"first_name": "GLORIA",
"middle_name": "YRIZARRY",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-01",
"last_updated": "2008-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NJ",
"license": "NJ1720",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NJ LICENSE",
"identifier": "1720",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Colts Neck, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.