MEDICARE: DR. MITCHELL CHARLES WEISER 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	207X00000X	Orthopaedic Surgery Physician	60-267526	NY

General Provider Information

NPI Number	:	1619266863
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MITCHELL CHARLES WEISER MD

Provider Business Mailing Address
First Line	:	ONE GUSTAVE LEVY PLACE
Second Line	:	MOUNT SINAI MEDICAL CENTER
City	:	NEW YORK
State	:	NY
Zip	:	10029
Country	:	US
Telephone Number	:	212-241-6500
Fax Number	:

Provider Business Practice Location Address
First Line	:	5 EAST 98TH ST
Second Line	:	DEPARTMENT OF ORTHOPAEDICS BOX 1188
City	:	NEW YORK
State	:	NY
Zip	:	10029
Country	:	US
Telephone Number	:	212-241-1621
Fax Number	:

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

Provider Enumeration Date	:	03/28/2011
Last Update Date	:	11/26/2012

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