Provider Demographics
NPI:1982016333
Name:WEISS, ERICA F (PHD)
Entity Type:Individual
Prefix:DR
First Name:ERICA
Middle Name:F
Last Name:WEISS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3230 BAINBRIDGE AVE STE C
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-3963
Mailing Address - Country:US
Mailing Address - Phone:718-944-1832
Mailing Address - Fax:718-944-1940
Practice Address - Street 1:3230 BAINBRIDGE AVE STE C
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-3963
Practice Address - Country:US
Practice Address - Phone:718-944-1832
Practice Address - Fax:718-944-1940
Is Sole Proprietor?:No
Enumeration Date:2014-05-20
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY020738103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist