Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 2317 | ME |
N | 2080P0207X | Pediatric Hematology-Oncologist | 25MB08085000 | NJ |
NPI | 1013945708 |
---|---|
Provider Name | Aaron R Weiss |
First Address | Scarborough, ME 04074-9701 |
Second Address | Scarborough, ME 04074-9692 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 01/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0107361 | (05) | NJ |