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General NPI Number Information
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NPI Number | 1558448605
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Entity Type | Individual
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Provider Name | CAROL WEISS RN P
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Gender | Female
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 492 MAIN ST
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City | CHATHAM
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State | NJ
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Zip | 07928-2142
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Country | US
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Telephone | 973-971-7184
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Fax | 973-290-8349
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Provider Business Mailing Address
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Address Line | PRACTICE ASSOCIATES MEDICAL GROUP PA PO BOX 23831
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City | NEWARK
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State | NJ
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Zip | 07189-0001
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Country | US
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Telephone | 973-656-6280
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 26NN06712800
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License Number State | NJ
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