Individual provider Active NPI

Benjamin Z. Weiss, PHD.

  • Psychologist
  • Lawrence, NY
National Provider Identifier
1306153804
Registry record updated Sep 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
9947-1 Issued in NY
Practice address
360 Central Avenue-Suite 110
Suite 110
Lawrence, NY 11559
Phone
(516) 569-4982
NPI assigned
Sep 3, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 9947-1 NY Primary

Addresses

Primary practice location

360 Central Avenue-Suite 110
Suite 110
Lawrence, NY 11559

Mailing address

360 Central Avenue-Suite 110
Suite 110
Lawrence, NY 11559

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
9947-1NYMDPsychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1283472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283472000000",
    "number": "1306153804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 CENTRAL AVENUE-SUITE 110",
            "address_2": "SUITE 110",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "11559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 CENTRAL AVENUE-SUITE 110",
            "address_2": "SUITE 110",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "11559",
            "telephone_number": "516-569-4982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISS",
        "first_name": "BENJAMIN",
        "middle_name": "Z.",
        "name_prefix": "Dr.",
        "credential": "PHD.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-03",
        "last_updated": "2010-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "9947-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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.

Verify at the official NPI Registry.