Provider Demographics
NPI:1407863236
Name:WEINBERG, HUBERT (MD)
Entity type:Individual
Prefix:
First Name:HUBERT
Middle Name:
Last Name:WEINBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-1031
Mailing Address - Country:US
Mailing Address - Phone:917-492-4200
Mailing Address - Fax:917-492-4300
Practice Address - Street 1:1050 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-1031
Practice Address - Country:US
Practice Address - Phone:917-492-4200
Practice Address - Fax:917-492-4300
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY131790208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00716490Medicaid
C11879Medicare UPIN
NY00716490Medicaid