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General NPI Number Information
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NPI Number | 1528658564
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Entity Type | Individual
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Provider Name | STEVEN WILLIAM WEAVER JR. PA-C
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Gender | Male
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Dates
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Enumeration Date | 01/23/2021
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Last Update Date | 01/23/2021
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Provider Practice Location Address
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Address Line | 1400 ALTAMONT AVE
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City | SCHENECTADY
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State | NY
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Zip | 12303-2909
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Country | US
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Telephone | 518-264-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 16 1ST ST
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City | COHOES
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State | NY
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Zip | 12047-3639
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Country | US
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Telephone | 518-928-6357
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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 | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 026072
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License Number State | NY
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