Provider Demographics
NPI:1104130624
Name:WEINSTEIN, ANTONIA ALBA (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:ANTONIA
Middle Name:ALBA
Last Name:WEINSTEIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:835 LEPUS CT SE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-2818
Mailing Address - Country:US
Mailing Address - Phone:505-410-9618
Mailing Address - Fax:505-819-5851
Practice Address - Street 1:3298 CERRILLOS RD
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-2925
Practice Address - Country:US
Practice Address - Phone:505-474-3523
Practice Address - Fax:505-474-3394
Is Sole Proprietor?:No
Enumeration Date:2010-07-27
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00007502183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist