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Individual

MR. SCOTT DOUGLAS WEILAND

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
TCH

Contact information

Practice address
39 LAKESIDE BLVD, HOPATCONG, NJ 07843-1311
(862) 707-8188
Mailing address
117 MAIN ST APT 2, ANDOVER, NJ 07821-4578
(973) 903-4767

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
1120215
NJ
174400000X
Specialist
Primary
1120216
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1120215
NJ
05
1120216
NJ
Enumeration date
03/06/2019
Last updated
03/06/2019
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