Healthcare Provider Details

I. General information

NPI: 1669430666
Provider Name (Legal Business Name): MEREDITH B PREVOR-WEISS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 10/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

955 YONKERS AVE STE 105
YONKERS NY
10704-3063
US

IV. Provider business mailing address

955 YONKERS AVE STE 105
YONKERS NY
10704-3063
US

V. Phone/Fax

Practice location:
  • Phone: 914-237-2002
  • Fax: 914-237-3002
Mailing address:
  • Phone: 914-237-2002
  • Fax: 914-237-3002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number25MA07890300
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number226151
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: