Provider Demographics
NPI:1548809072
Name:WEISS, ROBERT A (PT, DPT)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:A
Last Name:WEISS
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ROBERT
Other - Middle Name:A
Other - Last Name:WEISS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:5429 HARDING HWY
Mailing Address - Street 2:
Mailing Address - City:MAYS LANDING
Mailing Address - State:NJ
Mailing Address - Zip Code:08330-2263
Mailing Address - Country:US
Mailing Address - Phone:609-625-5000
Mailing Address - Fax:
Practice Address - Street 1:5429 HARDING HWY STE 203
Practice Address - Street 2:
Practice Address - City:MAYS LANDING
Practice Address - State:NJ
Practice Address - Zip Code:08330-2263
Practice Address - Country:US
Practice Address - Phone:609-625-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-01
Last Update Date:2020-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA018296002251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic