Healthcare Provider Details

I. General information

NPI: 1760498489
Provider Name (Legal Business Name): JANET IRENE PLOTKIN-BORNSTEIN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 05/03/2024
Certification Date: 01/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

736 WEST END AVENUE APARTMENT 10D
NEW YORK NY
10025
US

IV. Provider business mailing address

736 WEST END AVENUE APARTMENT 10D
NEW YORK NY
10025
US

V. Phone/Fax

Practice location:
  • Phone: 212-865-0443
  • Fax:
Mailing address:
  • Phone: 212-865-0443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number012188
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: