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NPI Code Detail

MEDICARE: MS. MARY-JO D. WEBER NP

MEDICARE: MS. MARY-JO D. WEBER NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse PractitionerF400379NY
2364SP0807XChild & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist001681CT

General Provider Information

NPI Number : 1538226667
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARY-JO D. WEBER NP
Provider Business Mailing Address
First Line : 240 LOCUST LN
Second Line :
City : IRVINGTON
State : NY
Zip : 10533-2315
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 800 CROSS RIVER RD
Second Line :
City : KATONAH
State : NY
Zip : 10536-3549
Country : US
Telephone Number : 914-763-8151
Fax Number : 877-810-1175
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/01/2007
Last Update Date : 03/11/2014

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