1659350882 NPI number — MAURICE D WEISS M.D.

Table of content: MAURICE D WEISS M.D. (NPI 1659350882)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659350882 NPI number — MAURICE D WEISS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WEISS
Provider First Name:
MAURICE
Provider Middle Name:
D
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1659350882
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/30/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1820 STATE ROUTE 33
Provider Second Line Business Mailing Address:
SUITE 4B
Provider Business Mailing Address City Name:
NEPTUNE
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07753-4860
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-776-8500
Provider Business Mailing Address Fax Number:
732-988-2347

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1820 STATE ROUTE 33
Provider Second Line Business Practice Location Address:
SUITE 4B
Provider Business Practice Location Address City Name:
NEPTUNE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07753-4860
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-776-8500
Provider Business Practice Location Address Fax Number:
732-988-2347
Provider Enumeration Date:
01/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  25MA06222800 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RI0011X , with the licence number: MA2506222800 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207UN0901X , with the licence number: 25MA06222800 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1326063 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6522203 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 223247181 . This is a "FIRST HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 223247181003 . This is a "QUALCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: NJ0012621 . This is a "TRICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0K2239 . This is a "HEALTHNET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 223247181 . This is a "HORIZON BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9191356004 . This is a "CIGNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: P628872 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0005850463 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 24693 . This is a "EMPIRE BLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0519165 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 060036053 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0797104000 . This is a "AMERIHEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 2101674 . This is a "GHI" identifier . This identifiers is of the category "OTHER".




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