Provider Demographics
NPI:1376720169
Name:WEISS, SCOTT H (DPM)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:H
Last Name:WEISS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 POST RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820-4622
Mailing Address - Country:US
Mailing Address - Phone:203-656-1696
Mailing Address - Fax:203-656-1742
Practice Address - Street 1:800 POST RD
Practice Address - Street 2:SUITE 302
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-4622
Practice Address - Country:US
Practice Address - Phone:203-656-1696
Practice Address - Fax:203-656-1742
Is Sole Proprietor?:No
Enumeration Date:2008-01-24
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000827213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT000827OtherCT LICENSC