Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | 26NJ01051400 | NJ |
Y | 363LA2100X | Nurse Practitioner - Acute Care | APRN11007959 | FL |
NPI | 1013529007 |
---|---|
Provider Name | Chuck Weiss |
First Address | Edison, NJ 08820-2795 |
Second Address | Edison, NJ 08820-2795 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2020 |
Last Update Date | 17/11/2020 |