Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | 11267 | CT |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DN1857534 | MA |
NPI | 1023426392 |
---|---|
Provider Name | Dr. Robert J Weinstock |
First Address | West Springfield, MA 01089-3258 |
Second Address | West Springfield, MA 01089 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2014 |
Last Update Date | 14/05/2021 |