Provider Demographics
NPI:1144575838
Name:WEISSMAN, ALAN JAY (MPS)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:JAY
Last Name:WEISSMAN
Suffix:
Gender:M
Credentials:MPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 BEACON HILL DRIVE
Mailing Address - Street 2:APT. 8AB3
Mailing Address - City:DOBBS FERRY
Mailing Address - State:NY
Mailing Address - Zip Code:10522-2463
Mailing Address - Country:US
Mailing Address - Phone:914-438-0198
Mailing Address - Fax:
Practice Address - Street 1:42 BEACON HILL DRIVE
Practice Address - Street 2:APT. 8AB3
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522-2463
Practice Address - Country:US
Practice Address - Phone:914-438-0198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY03685101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health