Provider Demographics
NPI:1700198116
Name:WEICHT, CAROLE-JAY CIAIO (MD)
Entity Type:Individual
Prefix:
First Name:CAROLE-JAY
Middle Name:CIAIO
Last Name:WEICHT
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 1:52 TROTTER CIR
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-9123
Mailing Address - Country:US
Mailing Address - Phone:412-749-3750
Mailing Address - Fax:
Practice Address - Street 1:52 TROTTER CIR
Practice Address - Street 2:
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-9123
Practice Address - Country:US
Practice Address - Phone:412-749-3750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-14
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD058112L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine