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General NPI Number Information
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NPI Number | 1487665832
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Entity Type | Individual
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Provider Name | ELLEN MARCIE WEISSMAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/11/2006
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Last Update Date | 05/01/2023
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Provider Practice Location Address
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Address Line | 39 SMITH AVE FRNT BLDG
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City | MOUNT KISCO
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State | NY
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Zip | 10549-2838
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Country | US
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Telephone | 914-997-7727
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Fax | 914-222-8885
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Provider Business Mailing Address
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Address Line | 39 SMITH AVE FRNT BLDG
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City | MOUNT KISCO
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State | NY
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Zip | 10549-2838
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Country | US
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Telephone | 914-997-7727
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Fax | 914-222-8885
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 216341-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0101048882
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License Number State | VA
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