Basic Information
Provider Information
NPI: 1497190482
EntityType: 2
ReplacementNPI:  
OrganizationName: THE WESTON GROUP INC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
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Credential:  
OtherOrganizationName: THE WESTON HEALTH CARE GROUP INC
OtherOrganizationType: 3
OtherLastName:  
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Mailing Information
Address1: 2222 SULLIVAN TRL
Address2:  
City: EASTON
State: PA
PostalCode: 180407958
CountryCode: US
TelephoneNumber: 8009449782
FaxNumber: 6104382046
Practice Location
Address1: 2147 DAVIE AVE
Address2:  
City: STATESVILLE
State: NC
PostalCode: 286259200
CountryCode: US
TelephoneNumber: 7048780123
FaxNumber: 7048788689
Other Information
ProviderEnumerationDate: 05/03/2013
LastUpdateDate: 10/22/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: WESTON
AuthorizedOfficialFirstName: RANDALL
AuthorizedOfficialMiddleName: A
AuthorizedOfficialTitleorPosition: CEO
AuthorizedOfficialTelephone: 8009449782
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X NCN193200000X MULTI-SPECIALTY GROUPRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 
235Z00000X NCN193200000X MULTI-SPECIALTY GROUPSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist 
225100000X NCY193200000X MULTI-SPECIALTY GROUPRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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