Individual
DR. JONATHAN H WEISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
111 S 11TH ST STE G8490, PHILADELPHIA, PA 19107
(215) 955-1120
Mailing address
111 S 11TH ST STE G8490, PHILADELPHIA, PA 19107-4824
(215) 955-1120
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
25MB05619400
NJ
207L00000X
Anesthesiology Physician
C2-0007023
DE
207L00000X
Anesthesiology Physician
Primary
OS006143L
PA
207L00000X
Anesthesiology Physician
OS7545
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001263113
—
PA
05
—
5331307
—
NJ
01
—
P00747608
RAILROAD MEDICARE PTAN
PA
Enumeration date
10/04/2005
Last updated
10/23/2019
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