Provider Demographics
NPI:1558627604
Name:WEISS, RONA T (PSYCHOLOGIST)
Entity Type:Individual
Prefix:DR
First Name:RONA
Middle Name:T
Last Name:WEISS
Suffix:
Gender:F
Credentials:PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 SOUTH SERVICE ROAD
Mailing Address - Street 2:SUITE-15
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577
Mailing Address - Country:US
Mailing Address - Phone:516-621-1955
Mailing Address - Fax:516-621-1955
Practice Address - Street 1:220 SOUTH SERVICE ROAD
Practice Address - Street 2:SUITE 15
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577
Practice Address - Country:US
Practice Address - Phone:516-621-1955
Practice Address - Fax:516-621-1955
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-03
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013249103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist