Provider Demographics
NPI:1467727453
Name:DR. INGRID VEISS MEDICAL PRACTICE PC
Entity Type:Organization
Organization Name:DR. INGRID VEISS MEDICAL PRACTICE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:INGRID
Authorized Official - Middle Name:
Authorized Official - Last Name:VEISS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-777-2332
Mailing Address - Street 1:119B FENIMORE RD
Mailing Address - Street 2:
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-3502
Mailing Address - Country:US
Mailing Address - Phone:914-226-8555
Mailing Address - Fax:914-207-8501
Practice Address - Street 1:944 N BROADWAY
Practice Address - Street 2:SUITE 208
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1304
Practice Address - Country:US
Practice Address - Phone:914-226-8555
Practice Address - Fax:914-207-8501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-09
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2254031207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty