MEDICARE: LEBA DRORIT WEISER PA-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	363A00000X	Physician Assistant	021716	NY

General Provider Information

NPI Number	:	1518461045
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEBA DRORIT WEISER PA-C

Provider Business Mailing Address
First Line	:	1345 RXR PLZ
Second Line	:
City	:	UNIONDALE
State	:	NY
Zip	:	11556-1301
Country	:	US
Telephone Number	:	516-453-0435
Fax Number	:

Provider Business Practice Location Address
First Line	:	1470 METROPOLITAN AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10462-7446
Country	:	US
Telephone Number	:	718-571-9270
Fax Number	:

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

Provider Enumeration Date	:	03/20/2018
Last Update Date	:	08/07/2019

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Directions to “ LEBA DRORIT WEISER PA-C” Practice Location

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