MEDICARE: DR. JEFFREY M WEINBERG 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	207N00000X	Dermatology Physician	206843	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	:	1689660565
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY M WEINBERG MD

Provider Business Mailing Address
First Line	:	200 RIVERSIDE BLVD APT 7I
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10069-0908
Country	:	US
Telephone Number	:	917-309-3881
Fax Number	:	913-490-1906

Provider Business Practice Location Address
First Line	:	8002 KEW GARDENS RD STE 107
Second Line	:
City	:	KEW GARDENS
State	:	NY
Zip	:	11415-3600
Country	:	US
Telephone Number	:	718-459-0900
Fax Number	:	718-459-0910

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

Provider Enumeration Date	:	09/26/2005
Last Update Date	:	05/19/2023

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