Individual
DR. JAY IRA WEISSMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
12B SMEDLEY LN, SUITE 1, NEWTOWN SQUARE, PA 19073-3206
(610) 356-3724
(610) 658-0927
Mailing address
12B SMEDLEY LN, SUITE 1, NEWTOWN SQUARE, PA 19073-3206
(610) 356-3724
(610) 658-0927
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
B10000503
DE
103TC0700X
Clinical Psychologist
Primary
PS 005215 L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0089393000
PERSONAL CHOICE
—
01
—
020720PHD
DE BLUE CROSS SHIELD
—
05
—
1000032392
—
DE
05
—
1000033857
—
DE
01
—
234431
COMPSYCH
—
01
—
2547468
AETNA
—
01
—
50294
CHRISTIANA CARE
—
01
—
628075
ANTHEM BLUE CROSS SHIELD
—
Enumeration date
12/09/2006
Last updated
07/09/2007
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