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General NPI Number Information
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NPI Number | 1407255227
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Entity Type | Organization
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Legal Business Name | RICHARD A. WEISS MD PC
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Dates
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Enumeration Date | 08/18/2014
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Last Update Date | 03/11/2015
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Provider Practice Location Address
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Address Line | 556 N COUNTRY RD STE 6
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City | SAINT JAMES
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State | NY
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Zip | 11780-1422
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Country | US
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Telephone | 631-686-6502
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Fax | 631-686-6504
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Provider Business Mailing Address
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Address Line | 556 N COUNTRY RD STE 6
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City | SAINT JAMES
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State | NY
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Zip | 11780-1422
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Country | US
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Telephone | 631-686-6502
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. KIMBERLY A TORTORELLA
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Credential |
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Telephone | 631-831-3237
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 1807281
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License Number State | NY
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