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General NPI Number Information
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NPI Number | 1669547014
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Entity Type | Individual
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Provider Name | JONATHAN HYMAN WEISS PHD
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Gender | Male
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10 E 78TH ST
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City | NEW YORK
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State | NY
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Zip | 10021-1713
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Country | US
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Telephone | 212-737-2575
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Fax | 212-737-2575
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Provider Business Mailing Address
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Address Line | 209 ARGYLE RD
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City | BROOKLYN
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State | NY
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Zip | 11218-3401
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Country | US
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Telephone | 718-284-5095
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Fax | 212-737-2575
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 3935
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License Number State | NY
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