Healthcare Provider Details

I. General information

NPI: 1316007024
Provider Name (Legal Business Name): MOSHE WEISS MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

258 OLD NYACK TURNPIKE
SPRING VALLEY NY
10977
US

IV. Provider business mailing address

12 GALILEO COURT
SUFFERN NY
10901
US

V. Phone/Fax

Practice location:
  • Phone: 845-371-8777
  • Fax: 845-371-7809
Mailing address:
  • Phone: 845-406-4608
  • Fax: 845-371-7809

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number219714
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number219714
License Number StateNY

VIII. Authorized Official

Name: MOSHE WEISS
Title or Position: PRESIDENT OWNER
Credential: MD
Phone: 845-406-4608