Provider Demographics
NPI:1013002872
Name:WEISS, GERSON (MD)
Entity Type:Individual
Prefix:DR
First Name:GERSON
Middle Name:
Last Name:WEISS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 TERRACE AVENUE
Mailing Address - Street 2:
Mailing Address - City:HASBROUCK HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07604
Mailing Address - Country:US
Mailing Address - Phone:201-288-6330
Mailing Address - Fax:201-288-6331
Practice Address - Street 1:214 TERRACE AVENUE
Practice Address - Street 2:
Practice Address - City:HASBROUCK HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:07604
Practice Address - Country:US
Practice Address - Phone:201-288-6330
Practice Address - Fax:201-288-6331
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA47439207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ634D31OtherWELLCHOICE
NJP2884941OtherOXFORD
NJ8213870OtherGHI
NJ0742898OtherCIGNA
NJJ28948OtherHEALTHNET
NJ4300567OtherAETNA
NJ634D31OtherEMPIRE BC
NJ1960105OtherUNITED HEALTHCARE
NJ79914OtherGREAT WEST
NJ820584930OtherHORIZON BC/BS OF NJ
NJP2884941OtherOXFORD
NJJ28948OtherHEALTHNET