Provider Demographics
NPI:1457646176
Name:WEISS, NANCY C (PT)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:C
Last Name:WEISS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6460 FAWN LN
Mailing Address - Street 2:
Mailing Address - City:CENTER VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:18034-9540
Mailing Address - Country:US
Mailing Address - Phone:610-390-9982
Mailing Address - Fax:
Practice Address - Street 1:300 E WINCHESTER AVE
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-2250
Practice Address - Country:US
Practice Address - Phone:215-757-3739
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-10
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA002573225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist