Provider Demographics
NPI:1730135906
Name:WEISS, ANTHONY J (OT)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:J
Last Name:WEISS
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 STITES AVE
Mailing Address - Street 2:PO BOX 874
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-2267
Mailing Address - Country:US
Mailing Address - Phone:609-463-9553
Mailing Address - Fax:609-463-9540
Practice Address - Street 1:9 STITES AVE
Practice Address - Street 2:
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-2267
Practice Address - Country:US
Practice Address - Phone:609-463-9553
Practice Address - Fax:609-463-9540
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2008-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00220900225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ223305571001OtherTRICARE / CHAMPUS
NJ223305571OtherUNITED HEALTHCARE GRP #
NJDD2634OtherRAILROAD MEDICARE GRP #
NJP00217703OtherRAILROAD MEDICARE PIN
NJ1602584OtherAMERIHEALTH PPO PIN
NJ223305571OtherCIGNA
NJ223305571OtherAETNA
NJ1602584OtherAMERIHEALTH PPO GRP #
NJ223305571OtherHORIZON BLUE SHIELD GRP #
NJ223305571OtherHORIZON MERCY HP GROUP #
NJP00217703Medicare PIN
NJ075240Medicare ID - Type UnspecifiedMEDICARE NJ