Provider Demographics
NPI:1891759684
Name:WEIDMAN, JOSHUA ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:ALAN
Last Name:WEIDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:841 FRANKLIN AVE
Mailing Address - Street 2:SUITE #5
Mailing Address - City:FRANKLIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07417-1418
Mailing Address - Country:US
Mailing Address - Phone:201-891-8811
Mailing Address - Fax:201-891-9010
Practice Address - Street 1:841 FRANKLIN AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:FRANKLIN LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07417
Practice Address - Country:US
Practice Address - Phone:201-891-8811
Practice Address - Fax:201-891-9010
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-17
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05252000207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ557708XZRMedicare PIN
E15308Medicare UPIN