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General NPI Number Information
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NPI Number | 1558504209
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Entity Type | Organization
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Legal Business Name | BARRY M WEINBERG DDS.PC.
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Dates
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Enumeration Date | 04/10/2009
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Last Update Date | 04/10/2009
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Provider Practice Location Address
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Address Line | 8340 AUSTIN ST
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City | KEW GARDENS
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State | NY
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Zip | 11415-1833
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Country | US
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Telephone | 718-847-4694
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Fax | 718-847-4695
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Provider Business Mailing Address
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Address Line | 8340 AUSTIN ST
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City | KEW GARDENS
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State | NY
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Zip | 11415-1833
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Country | US
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Telephone | 718-847-4694
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Fax | 718-847-4695
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BARRY M WEINBERG
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Credential | DDS
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Telephone | 718-847-4694
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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