Individual
RONALD D WEISSENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
400 N MAIN ST, WARSAW, NY 14569-1025
(585) 786-1249
(585) 861-6200
Mailing address
400 N MAIN ST, WARSAW, NY 14569-1025
(585) 786-1249
(866) 504-1133
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
277752
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04053687
—
NY
01
—
J400257354
MEDICARE PTAN (INDIVIDUAL)
NY
Enumeration date
09/24/2006
Last updated
12/18/2020
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