Provider Demographics
NPI:1396112900
Name:WEISS, JOSEPHINE (MSED)
Entity type:Individual
Prefix:MS
First Name:JOSEPHINE
Middle Name:
Last Name:WEISS
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 VALLEY VIEW TERRACE
Mailing Address - Street 2:
Mailing Address - City:MONTVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07645
Mailing Address - Country:US
Mailing Address - Phone:201-476-1494
Mailing Address - Fax:
Practice Address - Street 1:120 NORTH MAIN STREET, STE. 207
Practice Address - Street 2:HTA OF NEW YORK
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956
Practice Address - Country:US
Practice Address - Phone:845-638-3072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-31
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist