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NPI Code Detail

MEDICARE: ADAM JON WEIS MD

MEDICARE:   ADAM JON WEIS  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician285446-1NY

General Provider Information

NPI Number : 1144563644
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADAM JON WEIS MD
Provider Business Mailing Address
First Line : 6254 LAWVILLE RD
Second Line :
City : WOLCOTT
State : NY
Zip : 14590-9792
Country : US
Telephone Number : 315-594-9444
Fax Number : 315-594-1315
Provider Business Practice Location Address
First Line : 6254 LAWVILLE RD
Second Line :
City : WOLCOTT
State : NY
Zip : 14590-9792
Country : US
Telephone Number : 315-594-9444
Fax Number : 315-594-1315
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2013
Last Update Date : 05/06/2021

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Directions to “ ADAM JON WEIS MD” Practice Location

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