Provider Demographics
NPI:1811055932
Name:WEG, NOAH (MD)
Entity type:Individual
Prefix:
First Name:NOAH
Middle Name:
Last Name:WEG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 RUTH COURT
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-2448
Mailing Address - Country:US
Mailing Address - Phone:845-216-0066
Mailing Address - Fax:845-352-4423
Practice Address - Street 1:8 RUTH COURT
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-2448
Practice Address - Country:US
Practice Address - Phone:845-216-0066
Practice Address - Fax:845-352-4423
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10166412085R0202X
NJ25MA026649002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CR1016641OtherWORKERS COMP
521151Medicare ID - Type Unspecified
B15947Medicare UPIN