Healthcare Provider Details

I. General information

NPI: 1023920998
Provider Name (Legal Business Name): CHRISTOPHER FRANCIS WELLER PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 E 102ND ST
NEW YORK NY
10029-5611
US

IV. Provider business mailing address

69 TIEMANN PL
NEW YORK NY
10027-3351
US

V. Phone/Fax

Practice location:
  • Phone: 212-241-8462
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberP145423
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: