Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
N | 102L00000X | Psychologist | 00007158 | NY |
N | 103T00000X | Psychologist | 00007158 | NY |
Y | 103G00000X | Clinical Psychologist | 00007158 | NY |
Y | 103TC0700X | Clinical Psychologist | 00007158 | NY |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 00007158 | NY |
NPI | 1063863801 |
---|---|
Provider Name | Prof. Lissa Weinstein |
First Address | New York, NY 10128-0666 |
Second Address | New York, NY 10128-0666 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2016 |
Last Update Date | 23/06/2016 |