MEDICARE: PAUL K. WEIN MD PC

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
2	207RN0300X	Nephrology Physician	171752	NY
3	207R00000X	Internal Medicine Physician	137420	NY

General Provider Information

NPI Number	:	1932107703
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAUL K. WEIN MD PC

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	:	OFFICE MANAGER
Name	:	MRS. CATHERINE ROSE
Credential	:	M.D.
Telephone Number	:	718-338-2283

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	01/05/2010

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