Provider Demographics
NPI:1538241484
Name:WEISS, ROBERT LAWRENCE (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LAWRENCE
Last Name:WEISS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:40 CROSS ST
Mailing Address - Street 2:SUITE 230
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-4647
Mailing Address - Country:US
Mailing Address - Phone:203-845-2244
Mailing Address - Fax:203-845-2249
Practice Address - Street 1:40 CROSS ST
Practice Address - Street 2:SUITE 230
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-4647
Practice Address - Country:US
Practice Address - Phone:203-845-2244
Practice Address - Fax:203-845-2249
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT037572207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTG42119Medicare UPIN
CT04000319Medicare ID - Type Unspecified