Provider Demographics
NPI:1922252444
Name:FREDERICK J. WEISBROT M.D.P.A.
Entity Type:Organization
Organization Name:FREDERICK J. WEISBROT M.D.P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:J
Authorized Official - Last Name:WEISBROT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-997-2044
Mailing Address - Street 1:190 EAGLE ROCK AVENUE
Mailing Address - Street 2:PO BOX 393
Mailing Address - City:ROSELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:07068-0393
Mailing Address - Country:US
Mailing Address - Phone:201-997-2044
Mailing Address - Fax:201-997-2041
Practice Address - Street 1:190 EAGLE ROCK AVENUE
Practice Address - Street 2:
Practice Address - City:ROSELAND
Practice Address - State:NJ
Practice Address - Zip Code:07068-0393
Practice Address - Country:US
Practice Address - Phone:201-997-2044
Practice Address - Fax:201-997-2041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-11
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty