Active NPI
Mark S. Weiss, PSY.D.
- Clinical Psychologist
- Merrick, NY
National Provider Identifier
1003116831
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 01970
- Practice address
- 1841 Merrick Ave
Merrick, NY 11566-2736 - Phone
- (516) 374-6577
- Fax
- (516) 546-0654
- NPI assigned
- Oct 27, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 01970 | NY | Primary |
Addresses
Primary practice location
1841 Merrick Ave
Merrick, NY 11566-2736
Mailing address
1841 Merrick Ave
Merrick, NY 11566-2736
Phone (516) 374-6577
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01970 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288137600000",
"number": "1003116831",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1841 MERRICK AVE",
"city": "MERRICK",
"state": "NY",
"postal_code": "115662736",
"telephone_number": "516-374-6577",
"fax_number": "516-546-0654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1841 MERRICK AVE",
"city": "MERRICK",
"state": "NY",
"postal_code": "115662736",
"telephone_number": "516-374-6577",
"fax_number": "516-546-0654"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEISS",
"first_name": "MARK",
"middle_name": "S.",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-10-27",
"last_updated": "2010-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "01970",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Merrick, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.