Provider Demographics
NPI:1770592305
Name:WEIS, MICHAEL P (PT)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:P
Last Name:WEIS
Suffix:
Gender:M
Credentials:PT
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Mailing Address - Street 1:331 NEWMAN SPRINGS RD STE 220
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-5792
Mailing Address - Country:US
Mailing Address - Phone:732-807-0877
Mailing Address - Fax:201-751-1680
Practice Address - Street 1:1500 PLEASANT VALLEY WAY
Practice Address - Street 2:SUITE 102
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-2956
Practice Address - Country:US
Practice Address - Phone:973-325-3422
Practice Address - Fax:973-325-0825
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2024-06-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ40QA00550800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist