Individual
IRA M WEISSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
336 ELM ST, MALONE, NY 12953
(518) 483-0022
(518) 483-6179
Mailing address
336 ELM ST, MALONE, NY 12953
(518) 483-0022
(518) 483-6179
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
175855
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01082457
—
NY
Enumeration date
10/05/2006
Last updated
07/08/2007
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