Organization
CAYUGA COMPREHENSIVE PSYCHOLOGICAL SERVICES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JED H. WEITZEN PH.D. (OWNER)
(607) 273-6946
Entity
Organization
Contact information
Practice address
118 N TIOGA ST STE 302, ITHACA, NY 14850-4343
(607) 273-6946
(607) 256-1680
Mailing address
118 N TIOGA ST STE 302, ITHACA, NY 14850-4343
(607) 273-6946
(607) 256-1680
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
8507
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1497804900
NPI
NY
Enumeration date
11/17/2017
Last updated
11/17/2017
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