Basic Information
| Provider Information | |||||||||
| NPI: | 1962475319 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WEINMAN | ||||||||
| FirstName: | STEPHEN | ||||||||
| MiddleName: | RICHARD | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 222 ROUTE 299 | ||||||||
| Address2: | |||||||||
| City: | HIGHLAND | ||||||||
| State: | NY | ||||||||
| PostalCode: | 125282524 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8456913627 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 222 ROUTE 299 | ||||||||
| Address2: | |||||||||
| City: | HIGHLAND | ||||||||
| State: | NY | ||||||||
| PostalCode: | 125282524 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8456913627 | ||||||||
| FaxNumber: | 8456913641 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/08/2006 | ||||||||
| LastUpdateDate: | 08/06/2008 | ||||||||
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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 | 207QA0505X | 183371 | NY | Y | Allopathic & Osteopathic Physicians | Family Medicine | Adult Medicine |
No ID Information.