MEDICARE: DR. ALAN WEISMAN DPM

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	332B00000X	Durable Medical Equipment & Medical Supplies	SC005725L	PA
2	213ES0131X	Foot Surgery Podiatrist	N005894	NY

General Provider Information

NPI Number	:	1508820622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAN WEISMAN DPM

Provider Business Mailing Address
First Line	:	554 LARKFIELD RD STE 10C
Second Line	:
City	:	EAST NORTHPORT
State	:	NY
Zip	:	11731-4205
Country	:	US
Telephone Number	:	631-368-3668
Fax Number	:	631-368-3669

Provider Business Practice Location Address
First Line	:	554 LARKFIELD RD STE 10C
Second Line	:
City	:	EAST NORTHPORT
State	:	NY
Zip	:	11731-4205
Country	:	US
Telephone Number	:	631-368-3668
Fax Number	:	631-368-3669

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

Provider Enumeration Date	:	04/14/2006
Last Update Date	:	12/18/2025

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