Provider Demographics
NPI:1376144329
Name:WEISS, LAURA DEANN (RPH)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:DEANN
Last Name:WEISS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7142 ARLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-2915
Mailing Address - Country:US
Mailing Address - Phone:301-492-5161
Mailing Address - Fax:301-492-5190
Practice Address - Street 1:7142 ARLINGTON RD
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-2915
Practice Address - Country:US
Practice Address - Phone:301-492-5161
Practice Address - Fax:301-492-5190
Is Sole Proprietor?:No
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13234183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist