Provider Demographics
NPI:1598455420
Name:JOHANNES D WELTIN ND PC
Entity Type:Organization
Organization Name:JOHANNES D WELTIN ND PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHANNES
Authorized Official - Middle Name:D
Authorized Official - Last Name:WELTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-558-6565
Mailing Address - Street 1:6 WINDMILL DR
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-1201
Mailing Address - Country:US
Mailing Address - Phone:845-558-6565
Mailing Address - Fax:
Practice Address - Street 1:38 GLENBROOK RD
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-1310
Practice Address - Country:US
Practice Address - Phone:845-558-6565
Practice Address - Fax:845-354-3975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-12
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty