Provider Demographics
NPI:1982336384
Name:WEIN, SHIRA (PSYD)
Entity type:Individual
Prefix:DR
First Name:SHIRA
Middle Name:
Last Name:WEIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13747 76TH AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-2817
Mailing Address - Country:US
Mailing Address - Phone:347-886-1068
Mailing Address - Fax:
Practice Address - Street 1:205 LEXINGTON AVE FL 10
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6020
Practice Address - Country:US
Practice Address - Phone:212-335-0034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-26
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program