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General NPI Number Information
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NPI Number | 1316366693
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Entity Type | Individual
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Provider Name | ROBERT WEEMAN DDS
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Gender | Male
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Dates
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Enumeration Date | 04/15/2014
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Last Update Date | 04/15/2014
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Provider Practice Location Address
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Address Line | 39 BROADWAY
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City | NEW YORK
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State | NY
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Zip | 10006-3003
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Country | US
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Telephone | 212-422-9229
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Fax |
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Provider Business Mailing Address
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Address Line | 102 ROSE AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10306-2242
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Country | US
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Telephone | 917-882-7862
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 037585-1
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License Number State | NY
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