Provider Demographics
NPI:1831506799
Name:WEISS, KATHERINE MARIAN (RT (R) CT)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MARIAN
Last Name:WEISS
Suffix:
Gender:F
Credentials:RT (R) CT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:174 WESLEY CIR
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02346-1834
Mailing Address - Country:US
Mailing Address - Phone:508-944-8923
Mailing Address - Fax:
Practice Address - Street 1:174 WESLEY CIR
Practice Address - Street 2:
Practice Address - City:MIDDLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02346-1834
Practice Address - Country:US
Practice Address - Phone:508-944-8923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-11
Last Update Date:2014-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA018562471C3401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C3401XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistComputed Tomography