MEDICARE: GARY J WEINSTEIN

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	111N00000X	Chiropractor	DC002646L	PA

General Provider Information

NPI Number	:	1982613956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARY J WEINSTEIN

Provider Business Mailing Address
First Line	:	650 CHERRINGTON PKWY
Second Line	:
City	:	MOON TWP
State	:	PA
Zip	:	15108-4300
Country	:	US
Telephone Number	:	412-269-0444
Fax Number	:	412-269-1594

Provider Business Practice Location Address
First Line	:	650 CHERRINGTON PKWY
Second Line	:
City	:	MOON TWP
State	:	PA
Zip	:	15108-4300
Country	:	US
Telephone Number	:	412-269-0444
Fax Number	:	412-269-1594

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

Provider Enumeration Date	:	08/07/2006
Last Update Date	:	04/13/2011

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