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General NPI Number Information
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NPI Number | 1003973421
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Entity Type | Organization
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Legal Business Name | GERALD STEVEN WEINSTEIN
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 228 SHERMAN ST
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City | WATERTOWN
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State | NY
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Zip | 13601-3612
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Country | US
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Telephone | 315-788-9849
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Fax | 315-788-9458
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Provider Business Mailing Address
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Address Line | 228 SHERMAN ST
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City | WATERTOWN
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State | NY
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Zip | 13601-3612
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Country | US
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Telephone | 315-788-9849
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Fax | 315-788-9458
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | SUE E STORINO
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Credential |
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Telephone | 315-788-9849
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 144232
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License Number State | NY
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