Individual
JACOB RYAN WEISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 E LEHIGH AVE, PHILADELPHIA, PA 19125-1012
(215) 707-8483
Mailing address
100 E LEHIGH AVE STE 305B, PHILADELPHIA, PA 19125-1012
(215) 707-8483
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MT218510
PA
Other
Enumeration date
06/22/2019
Last updated
06/22/2019
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