Provider Demographics
NPI:1609933704
Name:WEISS, ELIZABETH LEE (PHD PSYCHOLOGIST)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:LEE
Last Name:WEISS
Suffix:
Gender:F
Credentials:PHD PSYCHOLOGIST
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Mailing Address - Street 1:3135 JOHNSON AVENUE APT 14E
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-3529
Mailing Address - Country:US
Mailing Address - Phone:718-884-9079
Mailing Address - Fax:718-884-9079
Practice Address - Street 1:2600 NETHERLAND AVE
Practice Address - Street 2:108
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-4801
Practice Address - Country:US
Practice Address - Phone:718-884-9079
Practice Address - Fax:718-884-9079
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY7500103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist