Provider Demographics
NPI:1962849331
Name:WEAVER, DAVID (RNFA)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:WEAVER
Suffix:
Gender:M
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 OLD RARITAN RD
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1021
Mailing Address - Country:US
Mailing Address - Phone:908-421-4124
Mailing Address - Fax:908-668-1766
Practice Address - Street 1:725 OLD RARITAN RD
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-1021
Practice Address - Country:US
Practice Address - Phone:908-421-4124
Practice Address - Fax:908-668-1766
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-25
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR08930300163WR0006X
NJ25MA08810500207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
No207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery