Provider Demographics
NPI:1083630339
Name:WEY, PHILIP DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:DAVID
Last Name:WEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 JOYCE KILMER AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-3363
Mailing Address - Country:US
Mailing Address - Phone:732-418-0709
Mailing Address - Fax:732-317-3064
Practice Address - Street 1:409 JOYCE KILMER AVE STE 210
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-3363
Practice Address - Country:US
Practice Address - Phone:732-418-0709
Practice Address - Fax:732-317-3064
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA059475208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJMA059475OtherLICENSE
NJF61691Medicare UPIN