Healthcare Provider Details

I. General information

NPI: 1730035643
Provider Name (Legal Business Name): NICOLE LOUISE WEINSHEIMER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2026
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3626 E TREMONT AVE
BRONX NY
10465-2030
US

IV. Provider business mailing address

377 PECAN ST
LINDENHURST NY
11757-4700
US

V. Phone/Fax

Practice location:
  • Phone: 347-871-3764
  • Fax:
Mailing address:
  • Phone: 631-804-1633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF02260620
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: