1982253258 NPI number — MISS LISA A WEEKS-CLOHESSY

Table of content: MISS LISA A WEEKS-CLOHESSY (NPI 1982253258)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982253258 NPI number — MISS LISA A WEEKS-CLOHESSY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WEEKS-CLOHESSY
Provider First Name:
LISA
Provider Middle Name:
A
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WEEKS
Provider Other First Name:
LISA
Provider Other Middle Name:
A.
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
MS SPED
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1982253258
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/26/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12 WHITE BIRCH DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OSSINING
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10562-2001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-329-4888
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15 SPRING VALLEY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OSSINING
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10562-2001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-333-7000
Provider Business Practice Location Address Fax Number:
914-333-7170
Provider Enumeration Date:
09/09/2019

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  598463121 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)