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NPI Code Detail

MEDICARE: NICHOLAS WEIS RN

MEDICARE:   NICHOLAS  WEIS  RN
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
1163WS0200XSchool Registered Nurse682128NY

General Provider Information

NPI Number : 1891292561
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLAS WEIS RN
Provider Business Mailing Address
First Line : 85 SHELL EDGE DR
Second Line :
City : ROCHESTER
State : NY
Zip : 14623-4356
Country : US
Telephone Number : 585-359-5413
Fax Number :
Provider Business Practice Location Address
First Line : 85 SHELL EDGE DR
Second Line :
City : ROCHESTER
State : NY
Zip : 14623-4356
Country : US
Telephone Number : 585-359-5413
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2018
Last Update Date : 04/10/2018

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