Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | 25MA 05047200 | NJ |
NPI | 1093910085 |
---|---|
Provider Name | Prof. Stanley H Weiss |
First Address | Livingston, NJ 07039-3716 |
Second Address | Livingston, NJ 07039-3716 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G19664 | (02) | NJ |
MA 6748503 | (05) | NJ |