Provider Demographics
NPI:1063546208
Name:WEISSMAN, ALLAN MARK (MD)
Entity type:Individual
Prefix:
First Name:ALLAN
Middle Name:MARK
Last Name:WEISSMAN
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:250 OLD HOOK RD
Mailing Address - Street 2:THE CENTER FOR PAIN MANAGEMENT
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-3123
Mailing Address - Country:US
Mailing Address - Phone:201-358-3647
Mailing Address - Fax:201-358-3596
Practice Address - Street 1:250 OLD HOOK RD
Practice Address - Street 2:THE CENTER FOR PAIN MANAGEMENT
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-3123
Practice Address - Country:US
Practice Address - Phone:201-358-3647
Practice Address - Fax:201-358-3596
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA06841300207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG46982Medicare UPIN