Provider Demographics
NPI:1912396466
Name:ETHOS PRIMARY CARE PC
Entity Type:Organization
Organization Name:ETHOS PRIMARY CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-867-0060
Mailing Address - Street 1:177 W MILL RD
Mailing Address - Street 2:
Mailing Address - City:LONG VALLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07853-3439
Mailing Address - Country:US
Mailing Address - Phone:908-867-0060
Mailing Address - Fax:908-867-0059
Practice Address - Street 1:177 W MILL RD
Practice Address - Street 2:
Practice Address - City:LONG VALLEY
Practice Address - State:NJ
Practice Address - Zip Code:07853-3439
Practice Address - Country:US
Practice Address - Phone:908-867-0060
Practice Address - Fax:908-867-0059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-21
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty