MEDICARE: DR. LEE WEITZMAN DDS

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
1	1223G0001X	General Practice Dentistry	032547	NY

General Provider Information

NPI Number	:	1265578082
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEE WEITZMAN DDS

Provider Business Mailing Address
First Line	:	26 PHIPPS LN
Second Line	:
City	:	PLAINVIEW
State	:	NY
Zip	:	11803-1926
Country	:	US
Telephone Number	:	516-931-0583
Fax Number	:

Provider Business Practice Location Address
First Line	:	6435 SPRINGFIELD BLVD
Second Line	:
City	:	OAKLAND GARDENS
State	:	NY
Zip	:	11364-2337
Country	:	US
Telephone Number	:	718-229-5500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	07/08/2007

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