JAY TILLMAN (NPI# 1497774384) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497774384 |
| Entity Type | Individual |
| Full Name | JAY TILLMAN |
| Credential | MD |
| Practice Address |
50 Albany Turnpike Canton Gateway Office Park #16 Canton CT 06019 |
| Mailing Address |
10 Fielding Woods West Granby CT 06090 |
| Practice Telephone | 8606938037 |
| Practice Fax Number | 8606938039 |
| Mailing Telephone | 8606938037 |
| Mailing Fax Number | 8606938039 |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
038679 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | BCBS | 01003867979CT02 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154501047 | Jay El Tillman | Counselor | 6885 Old Hwy 53, Clearlake, CA 95422 | 2007-11-07 |
| Street Address |
50 ALBANY TURNPIKE CANTON GATEWAY OFFICE PARK #16 |
| City | CANTON |
| State | CT |
| Zip Code | 06019 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679610505 | Andrea Prairie Tulley | Counselor | 50 Albany Turnpike, Suite #5022, Canton, CT 06019 | 2007-01-31 |
| 1114934270 | Thomas C Knee | Clinical Neuropsychologist | 50 Albany Turnpike, Canton Gateway Park Building 5, Canton, CT 06019 | 2006-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912532953 | Canton Geriatrics Pllc | Clinic/Center | 461 Cherry Brook Road, Canton, CT 06019 | 2020-03-10 |
| 1245877638 | Cara Noel Donahue | Social Worker | Farmington Valley Counseling Center, 111 Simsbury Rd, Avon, CT 06019 | 2019-12-04 |
| 1629614953 | Reformed Nutrition LLC | Dietitian, Registered | 220 Albany Turnpike, Unit 1, Canton, CT 06019 | 2019-11-21 |
| 1144607367 | Jordan Sileo Wasik | Counselor | 20 Depot St., Collinsville, CT 06019 | 2015-04-27 |
| 1578957361 | Glaser Helpers, Inc. | Home Health | 6 Wickhams Fancy, Collinsville, CT 06019 | 2015-03-19 |
| 1346686136 | Anna Sastre | Family Medicine | 117 Albany Turnpike, Canton, CT 06019 | 2013-05-20 |
| 1356698856 | Connecticut Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 111 Albany Turnpike, Canton, CT 06019 | 2012-08-14 |
| 1881858959 | Connecticut Foot Specialists PC | Podiatrist | 259 Albany Turnpike, Suite C, Canton, CT 06019 | 2008-07-17 |
| 1073734505 | Matthew Keefe | Dentist | 191 Albany Turnpike, Canton, CT 06019 | 2007-05-01 |
| 1710092432 | Gerard Edward-zackary Bogucki | Dentist | 66 Maple Avenue, Collinsville, CT 06019 | 2006-08-20 |
| Find all providers in zip 06019 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225471113 | Psychiatric Consulting Services PC | Psychiatry & Neurology | 40476 Glen Eagle Ln, Canton, MI 48188-2252 | 2013-04-10 |
| 1619201597 | Rajendra K Bhama | Psychiatry & Neurology | 7247 Chichester Rd, Canton, MI 48187-1436 | 2009-09-25 |
| 1609030147 | Hanif Ahmed Khan | Psychiatry & Neurology | 39894 Cheviot Rd, Canton, MI 48188-1524 | 2008-07-14 |
| 1295876308 | Stephen Melville Creel | Psychiatry & Neurology | 238 Bailey St, Canton, MA 02021-3903 | 2007-02-09 |
| 1376692665 | Comprehensive Psychiatric & Medical Services | Psychiatry & Neurology | 43311 Joy Rd, #177, Canton, MI 48187-2075 | 2007-01-09 |
| 1588727952 | Lavanya Subramanian | Psychiatry & Neurology | 191 Lamar Haley Parkway, Canton, GA 30114-8019 | 2006-12-18 |
| 1700969797 | Krutarth Choksi | Psychiatry & Neurology | 4974 Higbee Ave, Ste 209, Canton, OH 44718-2562 | 2006-10-23 |
| 1043304645 | Patricia Pielnik | Psychiatry & Neurology | 80 State Highway 310 Ste 1, Canton, NY 13617-1436 | 2006-10-03 |
| 1972524049 | Ikemefuna Nkanginieme | Psychiatry & Neurology | 4735 Belpar St Nw, Canton, OH 44718-3648 | 2006-07-22 |
| 1366463713 | Jeanette Niemisto | Psychiatry & Neurology | 8512 N Canton Center Rd, Canton, MI 48187-1310 | 2006-07-21 |
| Find all providers in CANTON | ||||
Please comment or provide details below to improve the information on JAY TILLMAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.