Provider Demographics
NPI:1407155146
Name:WEINER, VICTORIA KAY (MED)
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:KAY
Last Name:WEINER
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 WERNER RD
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-3409
Mailing Address - Country:US
Mailing Address - Phone:518-664-5066
Mailing Address - Fax:
Practice Address - Street 1:41 WERNER RD
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-3409
Practice Address - Country:US
Practice Address - Phone:518-664-5066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-21
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool