Healthcare Provider Details

I. General information

NPI: 1376720169
Provider Name (Legal Business Name): SCOTT H WEISS DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2008
Last Update Date: 01/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 POST RD SUITE 302
DARIEN CT
06820-4622
US

IV. Provider business mailing address

800 POST RD SUITE 302
DARIEN CT
06820-4622
US

V. Phone/Fax

Practice location:
  • Phone: 203-656-1696
  • Fax: 203-656-1742
Mailing address:
  • Phone: 203-656-1696
  • Fax: 203-656-1742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number000827
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: