Individual
MS. DIANE BETH WEISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
TSHH
Contact information
Practice address
12 RAE LANE, NORWALK, CT 06850
(516) 319-6882
Mailing address
12 RAE LANE, NORWALK, CT 06850
(516) 319-6882
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306194642
—
NY
Enumeration date
08/16/2012
Last updated
03/12/2015
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