Provider Demographics
NPI:1548435985
Name:WEISSMAN, ADAM SCOTT (PHD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:SCOTT
Last Name:WEISSMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 ALMENA AVE
Mailing Address - Street 2:
Mailing Address - City:ARDSLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10502-2127
Mailing Address - Country:US
Mailing Address - Phone:914-439-5759
Mailing Address - Fax:914-693-4807
Practice Address - Street 1:517 ALMENA AVE
Practice Address - Street 2:
Practice Address - City:ARDSLEY
Practice Address - State:NY
Practice Address - Zip Code:10502
Practice Address - Country:US
Practice Address - Phone:914-439-5759
Practice Address - Fax:914-693-4807
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-28
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019126-1103TC0700X, 103TC2200X, 103TF0000X, 103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily