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NPI Code Detail

MEDICARE: MATTHEW BRIAN WEISS D.C

MEDICARE: MATTHEW BRIAN WEISS D.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
1111N00000XChiropractorX007748NY

General Provider Information

NPI Number : 1811068364
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW BRIAN WEISS D.C
Provider Business Mailing Address
First Line : 13 PONY CIR
Second Line :
City : ROSLYN HEIGHTS
State : NY
Zip : 11577-1980
Country : US
Telephone Number : 718-575-0300
Fax Number :
Provider Business Practice Location Address
First Line : 6915 AUSTIN ST
Second Line :
City : FOREST HILLS
State : NY
Zip : 11375-4238
Country : US
Telephone Number : 718-575-0300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2006
Last Update Date : 07/08/2007

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