Provider Demographics
NPI:1265758700
Name:WEISSMAN, ANN L (MD)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:L
Last Name:WEISSMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 SAGAMORE WAY NORTH
Mailing Address - Street 2:
Mailing Address - City:JERICHO
Mailing Address - State:NY
Mailing Address - Zip Code:11753-2300
Mailing Address - Country:US
Mailing Address - Phone:516-551-2823
Mailing Address - Fax:
Practice Address - Street 1:33 SAGAMORE WAY NORTH
Practice Address - Street 2:
Practice Address - City:JERICHO
Practice Address - State:NY
Practice Address - Zip Code:11753-2300
Practice Address - Country:US
Practice Address - Phone:516-551-2823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-08
Last Update Date:2010-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY127928207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology