Provider Demographics
NPI:1093951261
Name:WEISS, NANCY (MS CCC/SLP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:WEISS
Suffix:
Gender:F
Credentials:MS CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 MEADOWLAWN ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-2763
Mailing Address - Country:US
Mailing Address - Phone:516-456-9945
Mailing Address - Fax:631-470-3289
Practice Address - Street 1:146 MEADOWLAWN ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2763
Practice Address - Country:US
Practice Address - Phone:516-456-9945
Practice Address - Fax:631-470-3289
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-18
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004647-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist