1629159892 NPI number — DR. HARVEY S WEINGARTEN MD

Table of content: DR. HARVEY S WEINGARTEN MD (NPI 1629159892)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629159892 NPI number — DR. HARVEY S WEINGARTEN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WEINGARTEN
Provider First Name:
HARVEY
Provider Middle Name:
S
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1629159892
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/08/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3270 STATE HIGHWAY ROUTE 27
Provider Second Line Business Mailing Address:
SUITE 1200
Provider Business Mailing Address City Name:
KENDALL PARK
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08824
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-422-2400
Provider Business Mailing Address Fax Number:
732-463-6087

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3270 STATE ROUTE 27
Provider Second Line Business Practice Location Address:
SUITE 1200
Provider Business Practice Location Address City Name:
KENDALL PARK
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08824-1496
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-422-2400
Provider Business Practice Location Address Fax Number:
732-463-6087
Provider Enumeration Date:
10/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  MA041110 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 222623593 . This is a "TAX ID" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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