Provider Demographics
NPI:1568450351
Name:WEISINGER, PHILIP ISRAEL (MD)
Entity Type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:ISRAEL
Last Name:WEISINGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:100 YORK ST
Mailing Address - Street 2:SUITE 2F
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-5620
Mailing Address - Country:US
Mailing Address - Phone:203-777-6455
Mailing Address - Fax:203-789-1960
Practice Address - Street 1:100 YORK ST
Practice Address - Street 2:SUITE 2F
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-5620
Practice Address - Country:US
Practice Address - Phone:203-777-6455
Practice Address - Fax:203-789-1960
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-06
Last Update Date:2021-08-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT13422207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001134220Medicaid
CT001134220Medicaid
CT030000033Medicare PIN
B39063Medicare UPIN