Basic Information
| Provider Information | |||||||||
| NPI: | 1124060108 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WEINBERGER | ||||||||
| FirstName: | BARRY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 66 WEST GILBERT ST | ||||||||
| Address2: | |||||||||
| City: | RED BANK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7322120051 | ||||||||
| FaxNumber: | 7322120713 | ||||||||
| Practice Location | |||||||||
| Address1: | UMDNJ-RWJ MEDICAL SCHOOL 1 RWJ PLACE | ||||||||
| Address2: | DEPT OF PEDIATRICS MEB 312-B | ||||||||
| City: | NEW BRUNSWICK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 08901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7322355684 | ||||||||
| FaxNumber: | 7322356609 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2006 | ||||||||
| LastUpdateDate: | 08/04/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 25MA05898100 | NJ | Y | Other Service Providers | Specialist |
ID Information
| ID | Type | State | Issuer | Description | 3416784 | 01 | NJ | AETNA HMO ID # | OTHER | 5727492 | 01 | NJ | AETNA PPO # | OTHER | F16261 | 01 | NJ | HEALTHNET ID # | OTHER | 15775 | 01 | NJ | HORIZON NJ HEALTH # | OTHER | 221494442 | 01 | NJ | TAX ID # | OTHER | 5502608 | 05 | NJ | MEDICAID | MI000012302 | 01 | NJ | AMERICHOICE # | OTHER | 60016798 | 01 | NJ | HORIZON NJ HEALTH # | OTHER | 18293 | 01 | NJ | AMERICAID # | OTHER |