MEDICARE: DR. PAUL KENNETH WEIN M.D.

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	207RC0000X	Cardiovascular Disease Physician	137420	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669470548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL KENNETH WEIN M.D.

Provider Business Mailing Address
First Line	:	3131 KINGS HWY
Second Line	:	SUITE D-6
City	:	BROOKLYN
State	:	NY
Zip	:	11234-2644
Country	:	US
Telephone Number	:	718-338-2283
Fax Number	:	718-338-1783

Provider Business Practice Location Address
First Line	:	3131 KINGS HWY
Second Line	:	SUITE D-6
City	:	BROOKLYN
State	:	NY
Zip	:	11234-2644
Country	:	US
Telephone Number	:	718-338-2283
Fax Number	:	718-338-1783

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

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	12/10/2007

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