MEDICARE: DR. JOYCE WEIL PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	006127	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	006127	OTHER	NY	NEW YORK STATE LICENSE
2	006127	OTHER	NY	NEW YORK STATE DEPT OF LICENSURE

General Provider Information

NPI Number	:	1649844325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOYCE WEIL PHD

Provider Business Mailing Address
First Line	:	15 W 81ST ST APT 15D
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10024-6022
Country	:	US
Telephone Number	:	917-743-8119
Fax Number	:

Provider Business Practice Location Address
First Line	:	945 5TH AVE OFC 2
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10021-2667
Country	:	US
Telephone Number	:	917-743-8119
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2021
Last Update Date	:	05/17/2021

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Directions to “ DR. JOYCE WEIL PHD” Practice Location

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