Provider Demographics
NPI:1740771815
Name:WEISS, MICHELE IVY (AUD, CCC-A, FAAA, F)
Entity Type:Individual
Prefix:MISS
First Name:MICHELE
Middle Name:IVY
Last Name:WEISS
Suffix:
Gender:F
Credentials:AUD, CCC-A, FAAA, F
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2870 HEMPSTEAD TPKE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756
Mailing Address - Country:US
Mailing Address - Phone:516-731-8600
Mailing Address - Fax:516-731-8746
Practice Address - Street 1:2870 HEMPSTEAD TPKE
Practice Address - Street 2:SUITE 200
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756
Practice Address - Country:US
Practice Address - Phone:516-731-8600
Practice Address - Fax:516-731-8746
Is Sole Proprietor?:No
Enumeration Date:2018-05-24
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
231H00000X
NY14000035529237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist