Individual
JASON D WEIDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
111 EAST ST 210 STREET, BRONX, NY 10467
(718) 920-4817
Mailing address
60 MELROSE AVE, BERGENFIELD, NJ 07621-2823
(718) 920-4817
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
064300
GA
2085R0202X
Diagnostic Radiology Physician
239046
MA
Other
Enumeration date
03/06/2009
Last updated
06/17/2021
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