Healthcare Provider Details

I. General information

NPI: 1598837981
Provider Name (Legal Business Name): ERIC S WEINER R.PH., D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WESTGATE
ELMONT NY
11003-2428
US

IV. Provider business mailing address

59 PLEASANTVIEW DR
CENTRAL ISLIP NY
11722-4691
US

V. Phone/Fax

Practice location:
  • Phone: 516-225-4546
  • Fax:
Mailing address:
  • Phone: 516-225-4546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number043452
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: