| Doctor Name: | THEODORE WEISS |
| NPI Number: | 1083634257 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | MD014735E |
| Business Practice Address: | 100 E Lancaster Ave 116 Lankenau Medical Building South Wynnewood, PA - 190963450 |
| Business Phone Number: | 6106497006 |
| Business Fax Number: | |
| Mailing Address: | 100 E Lancaster Ave, 116 Lankenau Medical Building South WYNNEWOOD |
| State: | PA |
| Postal Code: | 190963450 |
| Phone Number: | 6106497006 |
| Fax Number: | |
| NPI Enumeration Date: | 07/20/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | MD014735E |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |