Basic Information
| Provider Information | |||||||||
| NPI: | 1265410492 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WEISSBACH | ||||||||
| FirstName: | NANCY | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2314 SASSAFRAS ST | ||||||||
| Address2: | SUITE 310 | ||||||||
| City: | ERIE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 165022722 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8144566194 | ||||||||
| FaxNumber: | 8144525777 | ||||||||
| Practice Location | |||||||||
| Address1: | 2314 SASSAFRAS ST | ||||||||
| Address2: | SUITE 310 | ||||||||
| City: | ERIE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 165022722 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8144566194 | ||||||||
| FaxNumber: | 8144525777 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/06/2006 | ||||||||
| LastUpdateDate: | 10/06/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | MD046583L | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
No ID Information.