Individual
DR. JILL POLLER POLLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY. D.
Contact information
Practice address
11 RIVERSIDE DR APT 1PW, NEW YORK, NY 10023-2533
(212) 787-0331
Mailing address
11 RIVERSIDE DR APT 1PW, NEW YORK, NY 10023-2533
(212) 787-0331
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
6400
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6400
PSYCHOLOGIST LICENSE
NY
Enumeration date
08/13/2007
Last updated
08/13/2007
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