Provider Demographics
NPI:1891033411
Name:JOHN J WEITER, MD, PC
Entity Type:Organization
Organization Name:JOHN J WEITER, MD, PC
Other - Org Name:RETINA CONSULTANTS OF GREATER BOSTON, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:WEITER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-854-5090
Mailing Address - Street 1:60 EAST ST
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-4500
Mailing Address - Country:US
Mailing Address - Phone:617-864-6350
Mailing Address - Fax:
Practice Address - Street 1:39 CROSS ST STE 201
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-1666
Practice Address - Country:US
Practice Address - Phone:978-854-5090
Practice Address - Fax:978-854-5755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-17
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0031627Medicare Oscar/Certification