Healthcare Provider Details

I. General information

NPI: 1205914132
Provider Name (Legal Business Name): DR. SCOTT ALLEN WEINSTEIN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: SCOTT A WEINSTEIN MD, MBBS, PHD, MSC

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 E 42ND ST FL 8
NEW YORK NY
10017-5832
US

IV. Provider business mailing address

1 BAY CLUB DR APT 10X
BAYSIDE NY
11360-2908
US

V. Phone/Fax

Practice location:
  • Phone: 212-273-6100
  • Fax:
Mailing address:
  • Phone: 718-423-1913
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number242228
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: