Provider Demographics
NPI:1487665832
Name:WEISSMAN, ELLEN MARCIE (MD)
Entity Type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:MARCIE
Last Name:WEISSMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:39 SMITH AVE FRNT BLDG
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-2838
Mailing Address - Country:US
Mailing Address - Phone:914-997-7727
Mailing Address - Fax:914-222-8885
Practice Address - Street 1:39 SMITH AVE FRNT BLDG
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-2838
Practice Address - Country:US
Practice Address - Phone:914-997-7727
Practice Address - Fax:914-222-8885
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY216341-12084P0800X
VA01010488822084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry