Provider Demographics
NPI:1164638508
Name:WEISS, JAMES DENTON (MSW)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:DENTON
Last Name:WEISS
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 MOUNTAIN LAUREL RD
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-4066
Mailing Address - Country:US
Mailing Address - Phone:732-617-1492
Mailing Address - Fax:
Practice Address - Street 1:32 NARROWS RD S
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-2832
Practice Address - Country:US
Practice Address - Phone:718-815-4152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR0148571041C0700X
NJ44SC013787001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
N79491Medicare ID - Type Unspecified