MEDICARE: MISS ELIZABETH WEISS 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	023332	NY
2	363A00000X	Physician Assistant	023332-1	NY

General Provider Information

NPI Number	:	1851858765
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS ELIZABETH WEISS PA-C

Provider Business Mailing Address
First Line	:	334 KNOWLTON AVE
Second Line	:
City	:	KENMORE
State	:	NY
Zip	:	14217-2908
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 NORTH ST
Second Line	:
City	:	BATAVIA
State	:	NY
Zip	:	14020-1654
Country	:	US
Telephone Number	:	585-483-4081
Fax Number	:	585-483-3084

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

Provider Enumeration Date	:	02/27/2019
Last Update Date	:	04/23/2024

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Directions to “ MISS ELIZABETH WEISS PA-C” Practice Location

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