Provider Demographics
NPI:1235501115
Name:WEISS, NAOMI B (RN, BSN)
Entity Type:Individual
Prefix:MISS
First Name:NAOMI
Middle Name:B
Last Name:WEISS
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1276 OCEAN PKWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-5102
Mailing Address - Country:US
Mailing Address - Phone:718-689-0986
Mailing Address - Fax:
Practice Address - Street 1:1276 OCEAN PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-5102
Practice Address - Country:US
Practice Address - Phone:718-689-0986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-30
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY702744163W00000X
NJ26NR18312800163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse