Provider Demographics
NPI:1104896984
Name:WEISS, JEFFREY PAUL (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:PAUL
Last Name:WEISS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:800 POLY PL
Mailing Address - Street 2:MAIL ROUTING CODE 112A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-7104
Mailing Address - Country:US
Mailing Address - Phone:718-836-6600
Mailing Address - Fax:718-567-4043
Practice Address - Street 1:800 POLY PL
Practice Address - Street 2:MAIL ROUTING CODE 112A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-7104
Practice Address - Country:US
Practice Address - Phone:718-836-6600
Practice Address - Fax:718-567-4043
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2023-04-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD022505E208800000X
NY199634208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology