Healthcare Provider Details

I. General information

NPI: 1093758245
Provider Name (Legal Business Name): HANNA WEITZMAN NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 02/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

758 E 9TH ST
BROOKLYN NY
11230-2202
US

IV. Provider business mailing address

2030 S OCEAN DR APT 202
HALLANDALE BEACH FL
33009-6649
US

V. Phone/Fax

Practice location:
  • Phone: 305-331-8998
  • Fax:
Mailing address:
  • Phone: 305-331-8998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP 3280222
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number304844
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: