Provider Demographics
NPI:1104972017
Name:STEVEN S WEINSTEIN MD
Entity type:Organization
Organization Name:STEVEN S WEINSTEIN MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-693-0700
Mailing Address - Street 1:100 SHAMES DR
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-1741
Mailing Address - Country:US
Mailing Address - Phone:516-693-0700
Mailing Address - Fax:516-639-0271
Practice Address - Street 1:9717 64TH RD
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-2232
Practice Address - Country:US
Practice Address - Phone:718-575-9896
Practice Address - Fax:718-575-1253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY927985207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYD91813Medicare UPIN
NY34481Medicare ID - Type Unspecified