Provider Demographics
NPI:1457514861
Name:WEISFUSE, P DEBORAH (DMD)
Entity Type:Individual
Prefix:DR
First Name:P
Middle Name:DEBORAH
Last Name:WEISFUSE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 E 41 ST
Mailing Address - Street 2:#1100
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017
Mailing Address - Country:US
Mailing Address - Phone:212-685-4730
Mailing Address - Fax:212-685-4931
Practice Address - Street 1:12 E 41 ST
Practice Address - Street 2:#1100
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017
Practice Address - Country:US
Practice Address - Phone:212-685-4730
Practice Address - Fax:212-685-4931
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY34178122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist