Healthcare Provider Details

I. General information

NPI: 1396112900
Provider Name (Legal Business Name): JOSEPHINE WEISS M.S.ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2015
Last Update Date: 08/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 NORTH MAIN STREET, STE. 207 HTA OF NEW YORK
NEW CITY NY
10956
US

IV. Provider business mailing address

60 VALLEY VIEW TERRACE
MONTVALE NJ
07645
US

V. Phone/Fax

Practice location:
  • Phone: 845-638-3072
  • Fax:
Mailing address:
  • Phone: 201-476-1494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: