Provider Demographics
NPI:1578872396
Name:WEISS, JOSEPH (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:WEISS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 BLACKFOOT DR
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-4609
Mailing Address - Country:US
Mailing Address - Phone:732-446-2049
Mailing Address - Fax:732-446-5936
Practice Address - Street 1:145 MONMOUTH RD
Practice Address - Street 2:
Practice Address - City:WEST LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07764-1013
Practice Address - Country:US
Practice Address - Phone:732-542-6010
Practice Address - Fax:732-542-7875
Is Sole Proprietor?:No
Enumeration Date:2010-09-28
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01888400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist