Individual
RYAN EDWARD WEISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
130 DIVISION ST, DERBY, CT 06418-1326
(203) 735-7421
Mailing address
190 MARSHALL ST, WINSTED, CT 06098-2272
(860) 459-5114
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
6117
CT
363AM0700X
Medical Physician Assistant
Primary
6117
CT
Other
Enumeration date
03/20/2023
Last updated
02/20/2025
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