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General NPI Number Information
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NPI Number | 1760456057
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Entity Type | Individual
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Provider Name | ALAN B. WEINER MD
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Gender | Male
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Dates
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Enumeration Date | 02/14/2006
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Last Update Date | 02/28/2022
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Provider Practice Location Address
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Address Line | 401 KINGS HWY S
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City | CHERRY HILL
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State | NJ
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Zip | 08034-2500
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Country | US
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Telephone | 856-475-6166
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Fax |
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Provider Business Mailing Address
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Address Line | 474 GROVE ST
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City | WORCESTER
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State | MA
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Zip | 01605-1214
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Country | US
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Telephone | 508-403-7877
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Fax |
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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 | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | 25MA11214200
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 73864
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License Number State | MA
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