Provider Demographics
NPI:1902097785
Name:WEILLER, FENIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:FENIA
Middle Name:
Last Name:WEILLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 N. RIDGE ST.
Mailing Address - Street 2:
Mailing Address - City:RYE BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:10573
Mailing Address - Country:US
Mailing Address - Phone:914-939-5064
Mailing Address - Fax:
Practice Address - Street 1:16 SCHOOL ST
Practice Address - Street 2:LL STE. A
Practice Address - City:RYE
Practice Address - State:NY
Practice Address - Zip Code:10580-2952
Practice Address - Country:US
Practice Address - Phone:203-550-6582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002561103TA0700X, 103TC0700X, 103TC2200X
NY015707103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent