Provider Demographics
NPI:1730321449
Name:WEISS, HARVEY JEROME (MD)
Entity Type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:JEROME
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 1:520 SAINT NICHOLAS AVE
Mailing Address - Street 2:
Mailing Address - City:HAWORTH
Mailing Address - State:NJ
Mailing Address - Zip Code:07641-1633
Mailing Address - Country:US
Mailing Address - Phone:201-384-8826
Mailing Address - Fax:201-384-5257
Practice Address - Street 1:ST. LUKE'S-ROOSEVELT HOSPITAL
Practice Address - Street 2:1000 10TH AVE.
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019
Practice Address - Country:US
Practice Address - Phone:201-384-8826
Practice Address - Fax:201-384-2667
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-26
Last Update Date:2009-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY079036207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine