Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 26NJ01022300 | NJ |
NPI | 1013542984 |
---|---|
Provider Name | Paula Weisman |
First Address | Flanders, NJ 07836-9325 |
Second Address | Flanders, NJ 07836-9325 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2020 |
Last Update Date | 11/03/2020 |