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Individual

HERVEY A WEITZMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
175 JEFFERSON ST, FAIRFIELD, CT 06825-1078
(203) 365-6473
(203) 396-1039
Mailing address
175 JEFFERSON ST, FAIRFIELD, CT 06825-1078
(203) 365-6473
(203) 396-1039

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
24011
CT
207RH0003X
Hematology & Oncology Physician
Primary
24011
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001138940
CT
Enumeration date
07/12/2005
Last updated
02/09/2010
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