MEDICARE: DR. DANIEL MOSHE WEGLEIN 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
1	207R00000X	Internal Medicine Physician	197714	NY

General Provider Information

NPI Number	:	1588892087
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL MOSHE WEGLEIN MD

Provider Business Mailing Address
First Line	:	100 LAFAYETTE ST
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07304-3726
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	40 WORTH ST
Second Line	:	RM 1517
City	:	NEW YORK
State	:	NY
Zip	:	10013-2904
Country	:	US
Telephone Number	:	347-865-5691
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2009
Last Update Date	:	06/24/2009

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