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General NPI Number Information
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NPI Number | 1467527440
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Entity Type | Individual
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Provider Name | JEROME R WEINER MD
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Gender | Male
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 08/02/2016
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Provider Practice Location Address
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Address Line | 325 MEETING HOUSE LN BLDG 1 SUITE K
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City | SOUTHAMPTON
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State | NY
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Zip | 11968-5087
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Country | US
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Telephone | 631-283-8008
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Fax | 631-283-8870
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Provider Business Mailing Address
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Address Line | 57 HAMPTON RD SUITE 201
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City | SOUTHAMPTON
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State | NY
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Zip | 11968-4973
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Country | US
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Telephone | 631-283-2430
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Fax | 631-283-7496
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 137977
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License Number State | NY
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