Provider Demographics
NPI:1851586150
Name:WEISS, DANA ALEXANDRA (MD)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:ALEXANDRA
Last Name:WEISS
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 1:100 E PENN SQ
Mailing Address - Street 2:THE WANAMAKER BLDG. 9TH FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-3323
Mailing Address - Country:US
Mailing Address - Phone:267-425-9538
Mailing Address - Fax:267-425-9552
Practice Address - Street 1:34TH AND CIVIC CENTER BLVD DEPARTMENT
Practice Address - Street 2:CHILDREN'S HOSPITAL OF PHILADELPHIA -UROLOGY DEPT.
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4399
Practice Address - Country:US
Practice Address - Phone:215-590-2754
Practice Address - Fax:215-590-3985
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA102730208800000X
PAMD4491682088P0231X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2088P0231XAllopathic & Osteopathic PhysiciansUrologyPediatric Urology
No208800000XAllopathic & Osteopathic PhysiciansUrology