Basic Information
| Provider Information | |||||||||
| NPI: | 1457592313 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KAUFMAN | ||||||||
| FirstName: | JILL | ||||||||
| MiddleName: | BARNETT | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | LSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 50 FISHER AVENUE | ||||||||
| Address2: | |||||||||
| City: | PRINCETON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 08540 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6094002888 | ||||||||
| FaxNumber: | 8773436657 | ||||||||
| Practice Location | |||||||||
| Address1: | 707 ALEXANDER RD | ||||||||
| Address2: | STE 102 | ||||||||
| City: | PRINCETON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 085406331 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6099878100 | ||||||||
| FaxNumber: | 6099870574 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/23/2009 | ||||||||
| LastUpdateDate: | 10/28/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 44SC05416900 | NJ | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.