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Organization

NORTHERN VALLEY OBA, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JEFFREY A WEISS MD (PRESIDENT)
(561) 623-2000
Entity
Organization

Contact information

Practice address
375 ENGLE ST, SECOND FLOOR, ENGLEWOOD, NJ 07631-1823
(201) 871-6073
(201) 871-0619
Mailing address
7111 FAIRWAY DR, SUITE 450, PALM BEACH GARDENS, FL 33418-4204
(561) 623-2000
(865) 291-3612

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0078891
NJ
01
DC9942
RAILROAD MEDICARE
NJ
Enumeration date
10/12/2006
Last updated
01/25/2013
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