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NPI 1134760978

NPI 1134760978 : DAVID WEIR : POUGHKEEPSIE, NY

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General NPI Number Information
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    NPI Number           |    1134760978
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    Entity Type          |    Individual 
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    Provider Name        |    DAVID WEIR
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/02/2019
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    Last Update Date     |    10/02/2019
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Provider Practice Location Address
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    Address Line         |    18 HOFFMAN AVE 
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    City                 |    POUGHKEEPSIE
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    State                |    NY
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    Zip                  |    12603-1802
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    Country              |    US
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    Telephone            |    845-546-8488
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    18 HOFFMAN AVE 
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    City                 |    POUGHKEEPSIE
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    State                |    NY
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    Zip                  |    12603-1802
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    Country              |    US
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    Telephone            |    845-546-8488
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    343900000X
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    Taxonomy Name        |    Non-emergency Medical Transport (VAN)
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    License Number       |    641570273
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    License Number State |    NY
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