Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 30368 | MA |
NPI | 1003866351 |
---|---|
Provider Name | Dr. Irving Louis Weissman |
First Address | Brighton, MA 02135-3511 |
Second Address | Brighton, MA 02135-3511 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2006 |
Last Update Date | 28/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0023268 | NHP (01) | |
0096167 | AETNA (01) | |
0198862 | (05) | MA |
030368 | TUFTS HEALTH PLAN (01) | |
08-00059 | UNITED HEALTH CARE (01) | |
15275 | HARVARD PILGRAM NUMBER (01) | |
30368 | MEDICAL LICENSE NUMBER (01) | MA |
4832 | TARGET (01) | |
8194 | DAVIS (01) | |
96167 | U.S. HEALTH CARE (01) | |
A65853 | (02) | MA |