Provider Demographics
NPI:1356480123
Name:WEISS, JONA DIANA (MD)
Entity Type:Individual
Prefix:DR
First Name:JONA
Middle Name:DIANA
Last Name:WEISS
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Gender:F
Credentials:MD
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Mailing Address - Street 1:114 EAST 72ND STREET
Mailing Address - Street 2:JONA DIANA WEISS MD PC
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021
Mailing Address - Country:US
Mailing Address - Phone:212-988-6060
Mailing Address - Fax:212-988-1251
Practice Address - Street 1:114 EAST 72ND STREET
Practice Address - Street 2:JONA DIANA WEISS MD PC
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021
Practice Address - Country:US
Practice Address - Phone:212-988-6060
Practice Address - Fax:212-988-1251
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NY175570208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
F74462Medicare UPIN