Provider Demographics
NPI:1841214939
Name:WEISS, HAROLD H (MD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:H
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 1:1195 EAST 10TH STREET
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-4705
Mailing Address - Country:US
Mailing Address - Phone:718-692-2900
Mailing Address - Fax:718-692-2926
Practice Address - Street 1:1195 EAST 10TH STREET
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-4705
Practice Address - Country:US
Practice Address - Phone:718-692-2900
Practice Address - Fax:718-692-2926
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY135451207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00756276Medicaid
NY93A19Medicare ID - Type Unspecified
NY00756276Medicaid