Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 179403 | NY |
Y | 2080N0001X | Neonatal-Perinatal Doctor | 179403 | NY |
NPI | 1043287675 |
---|---|
Provider Name | Andrea Weintraub |
First Address | New York, NY 10029-6500 |
Second Address | New York, NY 10029-6500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2006 |
Last Update Date | 26/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01641276 | (05) | NY |