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General NPI Number Information
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NPI Number | 1881813319
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Entity Type | Individual
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Provider Name | JESSICA HEBRANK M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 426 WESTPORT AVE #1039
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City | NORWALK
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State | CT
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Zip | 06851
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Country | US
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Telephone | 646-260-1968
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Fax | 601-429-1750
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Provider Business Mailing Address
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Address Line | 426 WESTPORT AVE #1039
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City | NORWALK
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State | CT
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Zip | 06851
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Country | US
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Telephone | 646-260-1968
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Fax | 601-429-1750
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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 | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 240559
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 69417
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License Number State | CT
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