Healthcare Provider Details

I. General information

NPI: 1982253258
Provider Name (Legal Business Name): MISS LISA A WEEKS-CLOHESSY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LISA A. WEEKS MS SPED

II. Dates (important events)

Enumeration Date: 09/09/2019
Last Update Date: 06/26/2023
Certification Date: 06/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 SPRING VALLEY RD
OSSINING NY
10562-2001
US

IV. Provider business mailing address

12 WHITE BIRCH DRIVE
OSSINING NY
10562-2001
US

V. Phone/Fax

Practice location:
  • Phone: 914-333-7000
  • Fax: 914-333-7170
Mailing address:
  • Phone: 914-329-4888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number598463121
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: