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Individual

ILYA WEINER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PSYD

Contact information

Practice address
150 NEW PROVIDENCE RD, MOUNTAINSIDE, NJ 07092-2590
(908) 233-3720
Mailing address
150 NEW PROVIDENCE RD, MOUNTAINSIDE, NJ 07092-2590
(908) 233-3720

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
35SI004211200
NJ

Other

Enumeration date
08/28/2006
Last updated
07/08/2007
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