Healthcare Provider Details

I. General information

NPI: 1275568990
Provider Name (Legal Business Name): STUART M WEISS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 E 37TH ST STE 202A
NEW YORK NY
10016-3256
US

IV. Provider business mailing address

345 E 37TH ST STE 202A
NEW YORK NY
10016-3256
US

V. Phone/Fax

Practice location:
  • Phone: 212-935-0703
  • Fax:
Mailing address:
  • Phone: 201-487-7227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number175583
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: