Provider Demographics
NPI:1093068611
Name:STEVEN M. WEISSMAN, MD PLLC
Entity Type:Organization
Organization Name:STEVEN M. WEISSMAN, MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:WEISSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-853-7546
Mailing Address - Street 1:4 WESTON PL
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559-1525
Mailing Address - Country:US
Mailing Address - Phone:718-853-7546
Mailing Address - Fax:718-682-0146
Practice Address - Street 1:9413 FLATLANDS AVE
Practice Address - Street 2:SUITE 102 EAST
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-3726
Practice Address - Country:US
Practice Address - Phone:718-853-7546
Practice Address - Fax:718-682-0146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-19
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
No207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric DermatologyGroup - Single Specialty
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Single Specialty