MEDICARE: YAACOV WEISS

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	104100000X	Social Worker	101192	NY

General Provider Information

NPI Number	:	1437678281
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YAACOV WEISS

Provider Business Mailing Address
First Line	:	101 N CREST PL
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-2984
Country	:	US
Telephone Number	:	732-905-8804
Fax Number	:

Provider Business Practice Location Address
First Line	:	705B CROSS ST. SUITE 266
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-2984
Country	:	US
Telephone Number	:	732-552-5087
Fax Number	:

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

Provider Enumeration Date	:	09/13/2017
Last Update Date	:	03/23/2026

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Directions to “ YAACOV WEISS ” Practice Location

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