Provider Demographics
NPI:1053301770
Name:WEISER, TODD SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:SCOTT
Last Name:WEISER
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 1:33 DAVIS AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-1030
Mailing Address - Country:US
Mailing Address - Phone:914-681-2750
Mailing Address - Fax:914-681-2692
Practice Address - Street 1:33 DAVIS AVE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-1030
Practice Address - Country:US
Practice Address - Phone:914-681-2750
Practice Address - Fax:914-681-2692
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-25
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2168822086S0129X
NY2114612086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400062945Medicare PIN