Healthcare Provider Details

I. General information

NPI: 1093038226
Provider Name (Legal Business Name): JANET WEITZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2010
Last Update Date: 05/31/2025
Certification Date: 05/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

765 EAST ROUTE 70 BUILDING 100
MARLTON NJ
08053
US

IV. Provider business mailing address

765 EAST ROUTE 70 BUILDING 100
MARLTON NJ
08053
US

V. Phone/Fax

Practice location:
  • Phone: 856-983-3900
  • Fax: 856-810-0110
Mailing address:
  • Phone: 856-983-3900
  • Fax: 856-810-0110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ00281800
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number26NJ00281800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: