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NPI Code Detail

MEDICARE: TRACEY LEE WEIGEL MD

MEDICARE: TRACEY LEE WEIGEL MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery) Physician175287NY

General Provider Information

NPI Number : 1003870619
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACEY LEE WEIGEL MD
Provider Business Mailing Address
First Line : PO BOX 14890
Second Line :
City : ALBANY
State : NY
Zip : 12212-4890
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2231 BURDETT AVE STE 230
Second Line :
City : TROY
State : NY
Zip : 12180-2447
Country : US
Telephone Number : 518-271-5527
Fax Number : 518-833-7909
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2006
Last Update Date : 12/15/2025

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Directions to “ TRACEY LEE WEIGEL MD” Practice Location

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