Provider Demographics
NPI:1437436482
Name:WEISS, CHRISTINE F (OTR)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:F
Last Name:WEISS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 ROUTE 9W
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NY
Mailing Address - Zip Code:12542-5403
Mailing Address - Country:US
Mailing Address - Phone:845-236-5820
Mailing Address - Fax:845-236-5834
Practice Address - Street 1:1380 ROUTE 9W
Practice Address - Street 2:
Practice Address - City:MARLBORO
Practice Address - State:NY
Practice Address - Zip Code:12542-5403
Practice Address - Country:US
Practice Address - Phone:845-236-5820
Practice Address - Fax:845-236-5834
Is Sole Proprietor?:No
Enumeration Date:2011-11-04
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004683-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist