Individual
DR. JENNIFER W GILLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
99B MAIN ST, WESTHAMPTON BEACH, NY 11978-2607
(631) 288-3969
Mailing address
PO BOX 195, WESTHAMPTON, NY 11977-0195
(631) 682-0265
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
015710
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
497164
VALUE OPTIONS
NY
01
—
73361570
GHI/EMPIRE
NY
Enumeration date
08/31/2006
Last updated
07/21/2022
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