Healthcare Provider Details

I. General information

NPI: 1104822451
Provider Name (Legal Business Name): PAUL J. WEISER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 09/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 KUSER RD STE 514
HAMILTON NJ
08691-3800
US

IV. Provider business mailing address

3625 QUAKERBRIDGE RD
HAMILTON NJ
08619-1207
US

V. Phone/Fax

Practice location:
  • Phone: 609-585-8800
  • Fax: 609-585-1825
Mailing address:
  • Phone: 609-689-1600
  • Fax: 609-689-1200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMA03031700
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD017295E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: