Provider Demographics
NPI:1174805451
Name:SABA, JENNIFER FETNER (PHD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:FETNER
Last Name:SABA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:ALYSE
Other - Last Name:FETNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:108 BERKELEY PL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-3604
Mailing Address - Country:US
Mailing Address - Phone:718-594-0021
Mailing Address - Fax:
Practice Address - Street 1:108 BERKELEY PL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-3604
Practice Address - Country:US
Practice Address - Phone:917-589-5929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-13
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015855103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist