Provider Demographics
NPI:1235842154
Name:WEISSMANDL, MOISHE DOVID
Entity Type:Individual
Prefix:MR
First Name:MOISHE
Middle Name:DOVID
Last Name:WEISSMANDL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 36TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-3673
Mailing Address - Country:US
Mailing Address - Phone:718-854-6679
Mailing Address - Fax:
Practice Address - Street 1:SIPUK
Practice Address - Street 2:4102 13TH AVENUE
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219
Practice Address - Country:US
Practice Address - Phone:718-400-9988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health