| Doctor Name: | MR. GEORGE WEBER |
| NPI Number: | 1619110434 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | R.N. |
| License Number: | 599865-1 |
| Business Practice Address: | 638 Fresh Pond Ave Unit 351 Calverton, NY - 119331191 |
| Business Phone Number: | 6315652961 |
| Business Fax Number: | |
| Mailing Address: | 638 Fresh Pond Ave Unit 351, CALVERTON |
| State: | NY |
| Postal Code: | 119331191 |
| Phone Number: | 6315652961 |
| Fax Number: | |
| NPI Enumeration Date: | 04/09/2009 |
| NPI Last Update Date: | 07/30/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WG0000X |
| License Number: | 599865-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | General Practice |
| Taxonomy Definition: | |