Individual
JONATHAN WEBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2315 VICTORY BLVD, STATEN ISLAND, NY 10314-6623
(718) 477-6900
(718) 983-0352
Mailing address
2315 VICTORY BLVD, STATEN ISLAND, NY 10314-6623
(718) 477-6900
(718) 983-0352
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N005521
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005521-A11
HEALTHFIRST ID#
NY
01
—
009127301
AMERICHOICE #
NY
01
—
0130341
GHI PPO
NY
05
—
01977980
—
NY
01
—
134114612
TAX IDENTIFICATION NUMBER
NY
01
—
2702523
EVERCARE ID#
NY
01
—
5C8712
HEALTHNET
NY
01
—
7772241
AETNA PPO#
NY
01
—
N005521
HIP
NY
01
—
P3711260
OXFORD
NY
01
—
PK8941
EMPIRE BCBS
NY
01
—
WJ5521
ATLANTIS HEALTH PLAN
NY
Enumeration date
02/13/2006
Last updated
10/28/2022
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