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General NPI Number Information
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NPI Number | 1154521458
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Entity Type | Organization
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Legal Business Name | MARK R. WEIGLE, MD, P.C.
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Dates
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Enumeration Date | 07/24/2007
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Last Update Date | 04/29/2010
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Provider Practice Location Address
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Address Line | 140A LOCKWOOD AVE SUITE 2
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City | NEW ROCHELLE
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State | NY
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Zip | 10801-4915
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Country | US
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Telephone | 914-636-4466
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Fax | 914-636-0611
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Provider Business Mailing Address
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Address Line | 140A LOCKWOOD AVE SUITE 2
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City | NEW ROCHELLE
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State | NY
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Zip | 10801-4915
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Country | US
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Telephone | 914-636-4466
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Fax | 914-636-0611
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Authorized Official
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Title or Position | OWNER
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Name | MARK R. WEIGLE
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Credential | M.D.
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Telephone | 914-636-4466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 211099
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License Number State | NY
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