Provider Demographics
NPI:1477025559
Name:WEIZER, MARK
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:
Last Name:WEIZER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 MILL RD
Mailing Address - Street 2:
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046-2528
Mailing Address - Country:US
Mailing Address - Phone:215-887-8600
Mailing Address - Fax:
Practice Address - Street 1:1255 MILL RD
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-2528
Practice Address - Country:US
Practice Address - Phone:215-887-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-29
Last Update Date:2018-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant