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NPI Code Detail

MEDICARE: FAZIA WEAVER NP

MEDICARE: FAZIA WEAVER NP
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
1363LA2200XAdult Health Nurse Practitioner26NJ00313200NJ

General Provider Information

NPI Number : 1174828800
Entity Type Code : Individual
Provider Name (Legal Business Name) : FAZIA WEAVER NP
Provider Business Mailing Address
First Line : 300 POMPTON RD
Second Line :
City : WAYNE
State : NJ
Zip : 07470-2103
Country : US
Telephone Number : 973-720-5000
Fax Number :
Provider Business Practice Location Address
First Line : 300 POMPTON RD
Second Line :
City : WAYNE
State : NJ
Zip : 07470-2103
Country : US
Telephone Number : 973-720-2956
Fax Number : 973-720-2632
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2011
Last Update Date : 09/08/2016

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