Provider Demographics
NPI:1316016629
Name:JEFFREY WEISS MD PA
Entity type:Organization
Organization Name:JEFFREY WEISS MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:G
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-248-9199
Mailing Address - Street 1:44 ROUTE 23 NORTH
Mailing Address - Street 2:SUITE #6
Mailing Address - City:RIVERDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07457
Mailing Address - Country:US
Mailing Address - Phone:973-248-9199
Mailing Address - Fax:973-248-9299
Practice Address - Street 1:44 ROUTE 23 NORTH
Practice Address - Street 2:SUITE #6
Practice Address - City:RIVERDALE
Practice Address - State:NJ
Practice Address - Zip Code:07457
Practice Address - Country:US
Practice Address - Phone:973-248-9199
Practice Address - Fax:973-248-9299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA073792207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
P2721544OtherOXFORD
3440856OtherAETNA
P2721544OtherOXFORD
NJ079104Medicare ID - Type Unspecified