Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 202165 | NY |
NPI | 1124040530 |
---|---|
Provider Name | Dr. Kevin Harris Weiner |
First Address | Staten Island, NY 10308-3206 |
Second Address | Staten Island, NY 10308-3206 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 05/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1856625 | UHC (01) | NY |
2125718 | AETNA HMO (01) | NY |
2700601 | GHI (01) | NY |
4C7484 | HEALTHNET (01) | NY |
5128695 | AETNA PPO (01) | NY |
8U0471 | BLUE SHIELD (01) | NY |
G82848 | (02) | NY |
P1101731 | OXFORD (01) | NY |