Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 234028 | NY |
NPI | 1215139332 |
---|---|
Provider Name | Corey Weiner |
First Address | New York, NY 10087-9580 |
Second Address | Brooklyn, NY 11219 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2007 |
Last Update Date | 08/07/2007 |