MEDICARE: DR. JEFFREY S WEISMAN DO

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	207RC0000X	Cardiovascular Disease Physician	OS003794L	PA
2	207RC0000X	Cardiovascular Disease Physician	25MB03357200	NJ

General Provider Information

NPI Number	:	1649292426
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY S WEISMAN DO

Provider Business Mailing Address
First Line	:	6 NESHAMINY INTERPLEX
Second Line	:	SUITE 215
City	:	TREVOSE
State	:	PA
Zip	:	19053-6964
Country	:	US
Telephone Number	:	215-464-2200
Fax Number	:	215-639-3605

Provider Business Practice Location Address
First Line	:	6 NESHAMINY INTERPLEX
Second Line	:	SUITE 215
City	:	TREVOSE
State	:	PA
Zip	:	19053-6964
Country	:	US
Telephone Number	:	215-464-2200
Fax Number	:	215-639-3605

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

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	11/06/2015

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