Individual
MARJORIE WEIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC, CPHON, RN
Contact information
Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(212) 639-5952
Mailing address
1275 YORK AVE, NEW YORK, NY 10065-6007
(212) 639-5952
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
568414-1
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
F382261-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03711548
—
NY
Enumeration date
06/01/2012
Last updated
01/01/2016
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