Provider Demographics
NPI:1740390657
Name:WEILL, TERRY L (MD)
Entity type:Individual
Prefix:DR
First Name:TERRY
Middle Name:L
Last Name:WEILL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:350 CENTRAL PARK WEST
Mailing Address - Street 2:1G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025
Mailing Address - Country:US
Mailing Address - Phone:212-316-5818
Mailing Address - Fax:212-580-7219
Practice Address - Street 1:350 CENTRAL PARK WEST
Practice Address - Street 2:1G
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025
Practice Address - Country:US
Practice Address - Phone:212-316-5818
Practice Address - Fax:212-580-7219
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ1468002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
B05099Medicare UPIN
15D971Medicare ID - Type Unspecified