Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | 162500 | NY |
NPI | 1609345578 |
---|---|
Provider Name | Steven M Weiner |
First Address | New York, NY 10010-8149 |
Second Address | New York, NY 10010 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2018 |
Last Update Date | 02/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00000000 | N/A (01) | |
00000000 | NONE NOT APPLICABLE (01) |