Provider Demographics
NPI:1538279872
Name:WEISSMAN, DEBRA (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:
Last Name:WEISSMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-6012
Mailing Address - Country:US
Mailing Address - Phone:845-357-2177
Mailing Address - Fax:845-357-7095
Practice Address - Street 1:76 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-6012
Practice Address - Country:US
Practice Address - Phone:845-357-2177
Practice Address - Fax:845-357-7095
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235541208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics