Provider Demographics
NPI:1811280167
Name:NEISS, VIVIAN JOY (PHD)
Entity type:Individual
Prefix:
First Name:VIVIAN
Middle Name:JOY
Last Name:NEISS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 ROUND HILL RD
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-1537
Mailing Address - Country:US
Mailing Address - Phone:516-625-4446
Mailing Address - Fax:
Practice Address - Street 1:250 ROUND HILL RD
Practice Address - Street 2:
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577-1537
Practice Address - Country:US
Practice Address - Phone:516-625-4446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-19
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist