Physician Compare National (NPI:1164089223)

HEALTHCARE PROVIDER: JILL SPECTOR LCSW

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1164089223
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0547699332
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20200330002386
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SPECTOR
	Individual professional last name
Provider First Name	JILL
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	BERKELEY NORTHEASTERN STATE UNIVERSITY - COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1967
	Individual professional's medical school graduation year
Primary Specialty	CLINICAL SOCIAL WORKER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	171 W 4TH ST
	Group Practice or individual's line 1 address
Line 2 Street Address	APT 6
	Group Practice or individual's line 2 address
City	NEW YORK
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	100146841
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2122437716
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	M