Provider Demographics
NPI:1659350882
Name:WEISS, MAURICE D (MD)
Entity Type:Individual
Prefix:
First Name:MAURICE
Middle Name:D
Last Name:WEISS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 STATE ROUTE 33
Mailing Address - Street 2:SUITE 4B
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-4860
Mailing Address - Country:US
Mailing Address - Phone:732-776-8500
Mailing Address - Fax:732-988-2347
Practice Address - Street 1:1820 STATE ROUTE 33
Practice Address - Street 2:SUITE 4B
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-4860
Practice Address - Country:US
Practice Address - Phone:732-776-8500
Practice Address - Fax:732-988-2347
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06222800207RC0000X, 207UN0901X
NJMA2506222800207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1326063OtherUNITED HEALTHCARE
NJ6522203Medicaid
223247181OtherFIRST HEALTH
223247181003OtherQUALCARE
NJ0012621OtherTRICARE
0K2239OtherHEALTHNET
223247181OtherHORIZON BCBS
NJ9191356004OtherCIGNA
P628872OtherOXFORD
0005850463OtherAETNA
24693OtherEMPIRE BLUE CROSS
0519165OtherAETNA HMO
060036053OtherRAILROAD MEDICARE
NJ0797104000OtherAMERIHEALTH
2101674OtherGHI
0005850463OtherAETNA
NJ732840AXTMedicare ID - Type Unspecified