Individual
KEVIN C WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
12 E 97TH ST # 1C, NEW YORK, NY 10029-6918
(212) 426-4700
(212) 426-0006
Mailing address
2453 FARMERS AVE, BELLMORE, NY 11710
(516) 707-8606
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
011553
NY
Other
Enumeration date
10/25/2006
Last updated
05/18/2020
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