Provider Demographics
NPI:1437479029
Name:WEBER, AUBRE ANN (DO)
Entity Type:Individual
Prefix:DR
First Name:AUBRE
Middle Name:ANN
Last Name:WEBER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 SAINT JOHNS RD
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-5613
Mailing Address - Country:US
Mailing Address - Phone:203-427-8291
Mailing Address - Fax:
Practice Address - Street 1:195 SAINT JOHNS RD
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-5613
Practice Address - Country:US
Practice Address - Phone:203-427-8291
Practice Address - Fax:860-295-1341
Is Sole Proprietor?:No
Enumeration Date:2010-06-04
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT52244207R00000X
NY273215207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03718738Medicaid
NY03718738Medicaid