Basic Information
| Provider Information | |||||||||
| NPI: | 1114023363 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WEINAR | ||||||||
| FirstName: | MARVIN | ||||||||
| MiddleName: | A. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 500 GROVE ST | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | HADDON HEIGHTS | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080351761 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8567969200 | ||||||||
| FaxNumber: | 8567969397 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 CAMPBELL DR | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | WILLINGBORO | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080461067 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6098774545 | ||||||||
| FaxNumber: | 6098775129 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/15/2006 | ||||||||
| LastUpdateDate: | 07/01/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MA42581 | NJ | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1948847 | 01 | UNITED HEALTHCARE | OTHER | 3K5945 | 01 | HEALTHNET | OTHER | 9243538 | 01 | CIGNA | OTHER | 0070238000 | 01 | AMERIHEALTH, KEYSTONE , IBC | OTHER | P369990 | 01 | OXFORD | OTHER | 1079534 | 01 | HORIZON NJ HEALTH | OTHER | 1595806 | 05 | NJ | MEDICAID | 010002170 | 01 | AMERICHOICE | OTHER | 080128744 | 01 | NJ | INDIVIDUAL RR PTAN | OTHER | 19323 | 01 | UNIVERSITY HEALTHPLAN | OTHER | 0010419 | 01 | AETNA | OTHER | 080128744 | 01 | RR MEDICARE | OTHER |