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General NPI Number Information
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NPI Number | 1336419704
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Entity Type | Organization
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Legal Business Name | LEWIS J WEINSTEIN M D P C
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Dates
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Enumeration Date | 01/03/2012
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Last Update Date | 01/09/2012
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Provider Practice Location Address
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Address Line | 66 COMMACK RD SUITE 203
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City | COMMACK
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State | NY
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Zip | 11725-3405
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Country | US
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Telephone | 631-499-3733
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Fax | 631-499-3710
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Provider Business Mailing Address
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Address Line | 66 COMMACK ROAD SUITE 203
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City | COMMACK
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State | NY
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Zip | 11725-3405
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Country | US
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Telephone | 631-499-3733
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Fax | 631-499-3710
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Authorized Official
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Title or Position | OWNER
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Name | DR. LEWIS J WEINSTEIN
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Credential | M D
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Telephone | 631-499-3733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 138663
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License Number State | NY
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