Provider Demographics
NPI:1780611293
Name:WEISS, SCOTT A (DPT, ATC)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:A
Last Name:WEISS
Suffix:
Gender:M
Credentials:DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 AVENUE OF THE AMERICAS
Mailing Address - Street 2:PARAMOUNT WELLNESS / CONCOURSE LEVEL
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-6022
Mailing Address - Country:US
Mailing Address - Phone:347-507-5877
Mailing Address - Fax:347-507-5877
Practice Address - Street 1:1301 AVENUE OF THE AMERICAS
Practice Address - Street 2:PARAMOUNT WELLNESS / CONCOURSE LEVEL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-6022
Practice Address - Country:US
Practice Address - Phone:347-507-5877
Practice Address - Fax:347-507-5877
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023860-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQQ5151Medicare ID - Type Unspecified