Weaver, Jacqueline

Weaver, Jacqueline is an individual health care provider with primary practice located at 2215 Burdett Ave , Troy NY 12180-2466. She recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as her primary health care specialty. Weaver, Jacqueline can be contacted via phone (330) 493-4443.

Contact Information

Primary practice address
2215 Burdett Ave Troy NY 12180-2466
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 237968 New York

Profile Details

NPI number 1902946890
LBN Legal business name Weaver, Jacqueline
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 8th, 2007
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902946890 NPPES
New York MEDICAID 02705879

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