Provider Demographics
NPI:1356479356
Name:WEISS & WEISS PSYCHOLOGICAL ASSOCIATES PA
Entity type:Organization
Organization Name:WEISS & WEISS PSYCHOLOGICAL ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSALEE
Authorized Official - Middle Name:G
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:201-836-3738
Mailing Address - Street 1:1665 HANOVER STREET
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666
Mailing Address - Country:US
Mailing Address - Phone:201-836-3738
Mailing Address - Fax:201-836-4979
Practice Address - Street 1:1665 HANOVER STREET
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666
Practice Address - Country:US
Practice Address - Phone:201-836-3738
Practice Address - Fax:201-836-4979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ626103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WE739862Medicare PIN
WE610654C9WMedicare ID - Type Unspecified