Organization
JAMES WEAVER PSYCHOLOGICAL SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES WEAVER (PRESIDENT/OWNER)
(646) 239-9357
Entity
Organization
Contact information
Practice address
1994 E MAIN ST, MOHEGAN LAKE, NY 10547-1231
(646) 239-9357
Mailing address
38 ENLOE ST, LAKE PEEKSKILL, NY 10537-1201
(646) 239-9357
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
014825
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02696308
—
NY
Enumeration date
03/19/2013
Last updated
03/19/2013
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