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General NPI Number Information
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NPI Number | 1568760882
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Entity Type | Individual
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Provider Name | JENNIFER RAJENE WOLKIN PHD
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Gender | Female
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Dates
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Enumeration Date | 03/10/2011
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Last Update Date | 01/12/2015
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Provider Practice Location Address
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Address Line | 207 E 84TH ST 2ND FLOOR, NORTH WING
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City | NEW YORK
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State | NY
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Zip | 10028-2972
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Country | US
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Telephone | 516-603-1846
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Fax |
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Provider Business Mailing Address
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Address Line | 207 E 84TH ST 2ND FLOOR, NORTH WING
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City | NEW YORK
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State | NY
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Zip | 10028-2972
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Country | US
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Telephone | 516-603-1846
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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Taxonomy #3
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Taxonomy Code | 103TA0700X
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Taxonomy Name | Adult Development & Aging Psychologist
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Taxonomy #4
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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Taxonomy #5
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Taxonomy Code | 103TH0004X
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Taxonomy Name | Health Psychologist
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Taxonomy #6
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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