Provider Demographics
NPI:1912015249
Name:WEYL, STEVEN J (DC CA)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:J
Last Name:WEYL
Suffix:
Gender:M
Credentials:DC CA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 GARBER SQUARE
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450
Mailing Address - Country:US
Mailing Address - Phone:201-652-7888
Mailing Address - Fax:201-652-0809
Practice Address - Street 1:10 GARBER SQUARE
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450
Practice Address - Country:US
Practice Address - Phone:201-652-7888
Practice Address - Fax:201-652-0809
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00305500111N00000X
NJ24MZ00011200208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ456120Medicare ID - Type Unspecified