Provider Demographics
NPI:1417949702
Name:WEISS, ROBERT A (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:WEISS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:157 BRUSH HOLLOW CRES
Mailing Address - Street 2:
Mailing Address - City:RYE BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:10573-1623
Mailing Address - Country:US
Mailing Address - Phone:914-772-5455
Mailing Address - Fax:
Practice Address - Street 1:19 BRADHURST AVE
Practice Address - Street 2:STE. 1400
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10532-2140
Practice Address - Country:US
Practice Address - Phone:914-493-7583
Practice Address - Fax:914-594-4011
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2021-07-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY1128322080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00305642Medicaid
NY00305642Medicaid
NY333641Medicare ID - Type Unspecified