MEDICARE: DR. BARRY ALAN WEINSTEIN 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	207QA0505X	Adult Medicine Physician	106114	NY

General Provider Information

NPI Number	:	1639136500
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARRY ALAN WEINSTEIN MD

Provider Business Mailing Address
First Line	:	1445 MAPLE RD
Second Line	:
City	:	WILLIAMSVILLE
State	:	NY
Zip	:	14221-3562
Country	:	US
Telephone Number	:	716-634-7470
Fax Number	:	716-634-0592

Provider Business Practice Location Address
First Line	:	1445 MAPLE RD
Second Line	:
City	:	WILLIAMSVILLE
State	:	NY
Zip	:	14221-3562
Country	:	US
Telephone Number	:	716-634-7470
Fax Number	:	716-634-0592

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

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	07/08/2007

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