Provider Demographics
NPI:1700353760
Name:WEISS, DANIELLE LEAH
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:LEAH
Last Name:WEISS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 COLUMBIA TPKE STE 105
Mailing Address - Street 2:
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-1229
Mailing Address - Country:US
Mailing Address - Phone:973-765-9050
Mailing Address - Fax:973-765-0195
Practice Address - Street 1:256 COLUMBIA TPKE STE 105
Practice Address - Street 2:
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-1229
Practice Address - Country:US
Practice Address - Phone:973-765-9050
Practice Address - Fax:973-765-0195
Is Sole Proprietor?:No
Enumeration Date:2018-10-29
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator