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General NPI Number Information
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NPI Number | 1023256690
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Entity Type | Organization
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Legal Business Name | MARK H. WEINSTEIN, MD PC
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Dates
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Enumeration Date | 02/04/2009
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Last Update Date | 02/04/2009
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Provider Practice Location Address
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Address Line | 136 SHERMAN AVE 407
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City | NEW HAVEN
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State | CT
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Zip | 06511-5238
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Country | US
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Telephone | 203-624-0673
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Fax |
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Provider Business Mailing Address
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Address Line | 136 SHERMAN AVE 407
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City | NEW HAVEN
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State | CT
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Zip | 06511-5238
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Country | US
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Telephone | 203-624-0673
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARK H WEINSTEIN
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Credential | MD
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Telephone | 203-624-0673
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 018620
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License Number State | CT
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