Provider Demographics
NPI:1225149909
Name:WEISS, JOEY (DPT)
Entity Type:Individual
Prefix:DR
First Name:JOEY
Middle Name:
Last Name:WEISS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:461 FOSTER AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-7600
Mailing Address - Country:US
Mailing Address - Phone:646-388-2285
Mailing Address - Fax:
Practice Address - Street 1:2918 AVENUE M
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-4617
Practice Address - Country:US
Practice Address - Phone:646-388-2285
Practice Address - Fax:718-252-0615
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027043-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400001626Medicare PIN