Provider Demographics
NPI:1548315294
Name:WEISS DOMIS, SINDEE (MD)
Entity type:Individual
Prefix:
First Name:SINDEE
Middle Name:
Last Name:WEISS DOMIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 COMMUNITY DRIVE
Mailing Address - Street 2:NSUH DEPT OF GERIATRIC AND PALLIATIVE MEDICINE
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030
Mailing Address - Country:US
Mailing Address - Phone:516-562-8825
Mailing Address - Fax:516-562-8826
Practice Address - Street 1:300 COMMUNITY DRIVE
Practice Address - Street 2:NSUH DEPT OF GERIATRIC AND PALLIATIVE MEDICINE
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-3816
Practice Address - Country:US
Practice Address - Phone:516-562-8825
Practice Address - Fax:516-562-8826
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY175976207R00000X, 207RC0200X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF346Medicare UPIN
NY74K531Medicare PIN