Provider Demographics
NPI:1710993365
Name:FRANKEL, JAY BERNARD (PHD)
Entity type:Individual
Prefix:DR
First Name:JAY
Middle Name:BERNARD
Last Name:FRANKEL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 ROBERTS RD
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-3226
Mailing Address - Country:US
Mailing Address - Phone:201-303-2178
Mailing Address - Fax:
Practice Address - Street 1:300 MERCER ST APT 3L
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-6732
Practice Address - Country:US
Practice Address - Phone:201-303-2178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6952-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical