Healthcare Provider Details

I. General information

NPI: 1053486928
Provider Name (Legal Business Name): WEISSMAN & KROLL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 KILMER DR STE 215
MORGANVILLE NJ
07751-1561
US

IV. Provider business mailing address

25 KILMER DR STE 215
MORGANVILLE NJ
07751-1561
US

V. Phone/Fax

Practice location:
  • Phone: 732-591-8840
  • Fax: 732-591-2822
Mailing address:
  • Phone: 732-591-8840
  • Fax: 732-591-2822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMA31991
License Number StateNJ

VIII. Authorized Official

Name: DR. LAWRENCE WEISSMAN
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 732-591-8840