Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 117078 | NY |
NPI | 1013244185 |
---|---|
Provider Name | Richard B Weininger |
First Address | Claverack, NY 12513 |
Second Address | Hudson, NY 12534 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/11/2009 |
Last Update Date | 11/11/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
117078 | STATE LICENSE (01) | NY |
AW9623756 | DEA (01) | NY |