Healthcare Provider Details

I. General information

NPI: 1730290222
Provider Name (Legal Business Name): LORI WEINSTEIN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 BATH RD SUITE 202
BRISTOL PA
19007-3101
US

IV. Provider business mailing address

501 BATH RD SUITE 202
BRISTOL PA
19007-3101
US

V. Phone/Fax

Practice location:
  • Phone: 215-785-9272
  • Fax: 215-785-9825
Mailing address:
  • Phone: 215-785-9272
  • Fax: 215-785-9825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberOS0076424L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: