Individual
DR. MARISA WEISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 E LANCASTER AVE, WYNNEWOOD, PA 19096-3450
(610) 645-2433
Mailing address
1020A E BOAL AVE, BOALSBURG, PA 16827-1509
(814) 237-8627
(814) 238-0083
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
MD033799E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012702160001
—
PA
Enumeration date
07/29/2005
Last updated
09/22/2011
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