MEDICARE: PAUL WEISSMAN P.C.

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	207R00000X	Internal Medicine Physician	25MA04353000	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407166382
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAUL WEISSMAN P.C.

Provider Business Mailing Address
First Line	:	9 GAIL CT
Second Line	:
City	:	SPRINGFIELD
State	:	NJ
Zip	:	07081-2212
Country	:	US
Telephone Number	:	973-379-7990
Fax Number	:	973-379-1681

Provider Business Practice Location Address
First Line	:	377 JERSEY AVE
Second Line	:	SUITE 460
City	:	JERSEY CITY
State	:	NJ
Zip	:	07302-4325
Country	:	US
Telephone Number	:	201-332-4110
Fax Number	:	201-332-4122

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. PAUL WEISSMAN
Credential	:	M.D.
Telephone Number	:	973-379-7990

Provider Enumeration Date	:	10/13/2010
Last Update Date	:	10/13/2010

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