Provider Demographics
NPI:1902820616
Name:WEISS, ELIZABETH (PT, FOC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:WEISS
Suffix:
Gender:F
Credentials:PT, FOC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 OAK ST STE B
Mailing Address - Street 2:
Mailing Address - City:PAWLING
Mailing Address - State:NY
Mailing Address - Zip Code:12564-1024
Mailing Address - Country:US
Mailing Address - Phone:845-855-2661
Mailing Address - Fax:845-855-2672
Practice Address - Street 1:4 OAK ST STE B
Practice Address - Street 2:
Practice Address - City:PAWLING
Practice Address - State:NY
Practice Address - Zip Code:12564-1024
Practice Address - Country:US
Practice Address - Phone:845-855-2661
Practice Address - Fax:845-855-2672
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019133-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7673809OtherAETNA