Provider Demographics
NPI:1033117866
Name:WEISS, ROBERT F (DPM)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:F
Last Name:WEISS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 POST RD
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820-4622
Mailing Address - Country:US
Mailing Address - Phone:203-656-1696
Mailing Address - Fax:203-656-1742
Practice Address - Street 1:800 POST RD
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-4622
Practice Address - Country:US
Practice Address - Phone:203-656-1696
Practice Address - Fax:203-656-1742
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000219213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT300091359OtherTAX ID