MEDICARE: DR. JESSICA HEBRANK M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0804X	Child & Adolescent Psychiatry Physician	240559	NY
2	2084P0804X	Child & Adolescent Psychiatry Physician	69417	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881813319
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JESSICA HEBRANK M.D.

Provider Business Mailing Address
First Line	:	426 WESTPORT AVE #1039
Second Line	:
City	:	NORWALK
State	:	CT
Zip	:	06851
Country	:	US
Telephone Number	:	646-260-1968
Fax Number	:	601-429-1750

Provider Business Practice Location Address
First Line	:	426 WESTPORT AVE #1039
Second Line	:
City	:	NORWALK
State	:	CT
Zip	:	06851
Country	:	US
Telephone Number	:	646-260-1968
Fax Number	:	601-429-1750

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2007
Last Update Date	:	10/30/2024

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