Basic Information
Provider Information
NPI: 1841357175
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WEISS
FirstName: RAMI
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: OT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 798 MATTNER CT
Address2:  
City: RIVERVALE
State: NJ
PostalCode: 076756622
CountryCode: US
TelephoneNumber: 2016541877
FaxNumber:  
Practice Location
Address1: 1400 PELHAM PKWY S
Address2:  
City: BRONX
State: NY
PostalCode: 104611138
CountryCode: US
TelephoneNumber: 7189183060
FaxNumber: 7189184469
Other Information
ProviderEnumerationDate: 01/03/2007
LastUpdateDate: 03/03/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X010064NYY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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