Provider Demographics
NPI:1699919514
Name:CHRISTINE WEBER PH.D., PSYCHOLOGICAL SERVICES P.L.L.C.
Entity type:Organization
Organization Name:CHRISTINE WEBER PH.D., PSYCHOLOGICAL SERVICES P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:516-826-4500
Mailing Address - Street 1:2234 JACKSON AVE
Mailing Address - Street 2:SUITE #205
Mailing Address - City:SEAFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11783-2600
Mailing Address - Country:US
Mailing Address - Phone:516-826-4500
Mailing Address - Fax:516-826-4520
Practice Address - Street 1:2234 JACKSON AVE
Practice Address - Street 2:SUITE #205
Practice Address - City:SEAFORD
Practice Address - State:NY
Practice Address - Zip Code:11783-2600
Practice Address - Country:US
Practice Address - Phone:516-826-4500
Practice Address - Fax:516-826-4520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-22
Last Update Date:2013-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015133103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYVL-9601Medicare UPIN