Individual
JONATHAN R. WEISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, FCCP
Contact information
Practice address
518 BROADWAY, MONTICELLO, NY 12701-1157
(845) 794-1600
(845) 794-0749
Mailing address
111 MALTESE DR, MIDDLETOWN, NY 10940-2115
(845) 342-4774
(845) 343-8741
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
183248
NY
207RP1001X
Pulmonary Disease Physician
Primary
183248
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01498851
—
NY
01
—
183248-1
LICENSE
NY
Enumeration date
06/20/2005
Last updated
03/07/2023
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