MEDICARE: DR. HERBERT MICHAEL WEINMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD054530L	PA
2	207Q00000X	Family Medicine Physician	096623	NY

General Provider Information

NPI Number	:	1427055979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HERBERT MICHAEL WEINMAN MD

Provider Business Mailing Address
First Line	:	222 ROUTE 299
Second Line	:
City	:	HIGHLAND
State	:	NY
Zip	:	12528
Country	:	US
Telephone Number	:	845-691-3627
Fax Number	:

Provider Business Practice Location Address
First Line	:	222 ROUTE 299
Second Line	:
City	:	HIGHLAND
State	:	NY
Zip	:	12528
Country	:	US
Telephone Number	:	845-691-3627
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	10/18/2010

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