Healthcare Provider Details

I. General information

NPI: 1700884178
Provider Name (Legal Business Name): GLENN D WEINFELD D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2005
Last Update Date: 09/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 ROUTE 6 CAREMOUNT MEDICAL, PC
YORKTOWN HEIGHTS NY
10598-6349
US

IV. Provider business mailing address

110 S BEDFORD RD CAREMOUNT MEDICAL, PC
MOUNT KISCO NY
10549-3446
US

V. Phone/Fax

Practice location:
  • Phone: 914-241-1050
  • Fax: 914-248-4091
Mailing address:
  • Phone: 914-241-1050
  • Fax: 914-248-4091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberN005939
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: