Provider Demographics
NPI:1225237696
Name:WEISS, DEBORAH (FNP)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:
Last Name:WEISS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 SPUR RD
Mailing Address - Street 2:
Mailing Address - City:PUTNAM VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10579-1335
Mailing Address - Country:US
Mailing Address - Phone:845-526-8482
Mailing Address - Fax:845-526-8483
Practice Address - Street 1:145 HUGUENOT STREET
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-5200
Practice Address - Country:US
Practice Address - Phone:914-813-5190
Practice Address - Fax:914-813-5182
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF331-004363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily