Provider Demographics
NPI:1871815050
Name:WEISSTEIN, ELLEN MILLER (MS)
Entity Type:Individual
Prefix:MRS
First Name:ELLEN
Middle Name:MILLER
Last Name:WEISSTEIN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 WATERTOWN ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-6320
Mailing Address - Country:US
Mailing Address - Phone:781-861-8844
Mailing Address - Fax:
Practice Address - Street 1:6 WATERTOWN ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-6320
Practice Address - Country:US
Practice Address - Phone:781-861-8844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-16
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist