Provider Demographics
NPI:1326391566
Name:WEISZ, SARA B
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:B
Last Name:WEISZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 MERON DR UNIT 102
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-5700
Mailing Address - Country:US
Mailing Address - Phone:845-782-1399
Mailing Address - Fax:
Practice Address - Street 1:4 MERON DR UNIT 102
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-5700
Practice Address - Country:US
Practice Address - Phone:845-782-1399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-25
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst