Provider Demographics
NPI:1487647178
Name:BECKER-WEIDMAN, ARTHUR (PHD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:
Last Name:BECKER-WEIDMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 EMERALD TRL
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-8305
Mailing Address - Country:US
Mailing Address - Phone:716-810-0790
Mailing Address - Fax:716-636-6243
Practice Address - Street 1:5820 MAIN ST
Practice Address - Street 2:SUITE 406
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5776
Practice Address - Country:US
Practice Address - Phone:716-810-0790
Practice Address - Fax:716-636-6243
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-26
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD118321041C0700X
MA1059831041C0700X
NY054696-R1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000525107001OtherBLUECROSS PROVIDER NUMBER
NY000525107001OtherBLUECROSS PROVIDER NUMBER