MARK H WEIDNER (NPI# 1972680288) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972680288 |
| Entity Type | Individual |
| Full Name | MARK H WEIDNER |
| Credential | MD |
| Practice Address |
2 Broad Street Plz Broad Street Medical Group Glens Falls NY 12801-4363 |
| Mailing Address |
Po Box 304 Glens Falls NY 12801-0304 |
| Practice Telephone | 5189261770 |
| Practice Fax Number | 5189261799 |
| Mailing Telephone | 5189261770 |
| Mailing Fax Number | 5189261799 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2009-06-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
210870 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01609810 | 05 | |
| VT | 0VN1263 | 05 | |
| NY | MEDICARE | RB8388 | 01 |
| Street Address |
2 BROAD STREET PLZ BROAD STREET MEDICAL GROUP |
| City | GLENS FALLS |
| State | NY |
| Zip Code | 12801-4363 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144214503 | Thomas Kandora | Internal Medicine | 2 Broad Street Plz, Glens Falls, NY 12801-4363 | 2005-08-31 |
| 1376891317 | Glens Falls Hospital Inc | Internal Medicine | 2 Broad Street Plz, Broad Street Medical Group, Glens Falls, NY 12801-4789 | 2012-08-23 |
| 1518215565 | Glens Falls Hospital Inc | Otolaryngology | 2 Broad Street Plz, Adirondack Ent, Glens Falls, NY 12801-4363 | 2012-08-23 |
| 1144508144 | Elizabeth Hutchins | Nurse Practitioner | 2 Broad Street Plz, Broad Street Medical Group, Glens Falls, NY 12801-4363 | 2011-07-26 |
| 1255636239 | Catherine Reichen | Physical Therapist | 2 Broad Street Plz, Glens Falls, NY 12801-4363 | 2011-01-21 |
| 1174828636 | Robert J Collette | Physical Therapist | 2 Broad Street Plz, Glens Falls, NY 12801-4363 | 2011-01-14 |
| 1407151996 | Laura A Rhodes | Physical Therapist | 2 Broad Street Plz, Glens Falls, NY 12801-4363 | 2011-01-14 |
| 1669675203 | Raju Sadal | Physician Assistant | 2 Broad Street Plz, Broad Street Medical Group, Glens Falls, NY 12801-4363 | 2007-06-11 |
| 1417001025 | Sean Michael Kennedy | Otolaryngology | 2 Broad Street Plz, Adirondack Ent, Glens Falls, NY 12801-4363 | 2007-01-22 |
| 1861401416 | John Sconzo | Anesthesiology | 2 Broad Street Plz, Glens Falls, NY 12801-4363 | 2006-08-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629549399 | Upstate Vision Care, Pllc | Technician/Technologist | 206 Glen St. Suite 31b, Colvin Building, Glens Falls, NY 12801 | 2018-12-06 |
| 1043737356 | Tiffany Britt | Social Worker | 43 Kensington Rd, Glens Falls, NY 12801 | 2017-08-28 |
| 1922375922 | Kathleen A Callaghan | Registered Nurse | 43 Kensington Road, Glens Falls, NY 12801 | 2011-11-19 |
| 1043595531 | Nancy K. Carroll | Social Worker | 37 Broad St., Glens Falls, NY 12801 | 2011-10-15 |
| 1992027528 | Benjamin Alan Rametta | Pharmacist | 202 Broad Street, Walgreens, Glens Falls, NY 12801 | 2010-02-23 |
| 1194052563 | Angela M Lalla | Audiologist | 318 Ridge Street, Glens Sallas, NY 12801 | 2009-11-05 |
| 1407018591 | Marilyn J Bryan | Counselor | 4 Technical Park, Suite #3, #6, Glens Falls, NY 12801 | 2008-06-30 |
| 1104087667 | Chase Chiropractic LLC | Chiropractor | 17 Pine St. 1 Irongate Center, Suite 3, Glens Falls, NY 12801 | 2008-06-18 |
| 1619183571 | Glens Falls Crossings LLC | Skilled Nursing Facility | 170 Warren Street, Glens Falls, NY 12801 | 2007-05-15 |
| 1417099706 | Patricia Ann Cameron | Psychologist | 464 Glen Street, Glens Falls, NY 12801 | 2007-02-13 |
| Find all providers in zip 12801 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376891317 | Glens Falls Hospital Inc | Internal Medicine | 2 Broad Street Plz, Broad Street Medical Group, Glens Falls, NY 12801-4789 | 2012-08-23 |
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|---|---|---|---|---|
| 1275171472 | Health Quest Medical Practice, PC | Internal Medicine | 667 Stoneleigh Ave Ste 123, Carmel, NY 10512-2455 | 2019-12-18 |
| 1881255370 | Marc J Yunis Md PC | Internal Medicine | 1100 Stewart Ave Ste 2, Garden City, NY 11530-4839 | 2019-06-25 |
| 1750841953 | Live Well Medical Care, PC | Internal Medicine | 178 Dahill Rd Ste 1, Brooklyn, NY 11218-2255 | 2019-03-22 |
| 1124509278 | Andre Francis Charest | Internal Medicine | 462 Grider St Fl 11, Buffalo, NY 14215-3021 | 2018-08-27 |
| 1760960132 | Hn&d Company LLC | Internal Medicine | 33 Walt Whitman Rd Ste 114, Huntington Station, NY 11746-3676 | 2018-07-30 |
| 1669979720 | Ambreen Azhar | Internal Medicine | St Lukes Hospital Mount Sinai, 1111 Amsterdam Ave, Nyc, NY 10025 | 2018-04-06 |
| 1659898443 | Broadway Medical Care, P.C. | Internal Medicine | 4117 Judge St Fl 1, Elmhurst, NY 11373-2343 | 2017-08-23 |
| 1023539590 | Ismail Omran | Internal Medicine | 7901 Broadway # C7-10, Elmhurst, NY 11373-1329 | 2017-07-05 |
| 1932636636 | Marco Bonilla | Internal Medicine | 8345 Lefferts Blvd Apt 2c, Kew Gardens, NY 11415-2516 | 2017-05-12 |
| 1386190676 | Mubasshar Rehman | Internal Medicine | Division of Nephrology Mount Sinai St. Luke's Hospital, 1111 Amsterdam Avenue, New York, NY 10025 | 2016-08-28 |
| Find all providers with the same taxonomy | ||||
| City | GLENS FALLS |
| Zip Code | 12801 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.