1518040013 NPI number — MS. AMY RENEE WEINBERG NP AAHIVS

Table of content: MS. AMY RENEE WEINBERG NP AAHIVS (NPI 1518040013)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518040013 NPI number — MS. AMY RENEE WEINBERG NP AAHIVS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WEINBERG
Provider First Name:
AMY
Provider Middle Name:
RENEE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
NP AAHIVS
Provider Gender Code:
F

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:
1518040013
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3635 JOHNSON AVE
Provider Second Line Business Mailing Address:
APT 5L
Provider Business Mailing Address City Name:
BRONX
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10463-1625
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-432-6614
Provider Business Mailing Address Fax Number:
718-432-6614

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
166 WEST BROAD STREET SUITE 202
Provider Second Line Business Practice Location Address:
STAMFORD HOSPITAL
Provider Business Practice Location Address City Name:
STAMFORD
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-276-5510
Provider Business Practice Location Address Fax Number:
203-276-7597
Provider Enumeration Date:
10/20/2006

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: 363LF0000X , with the licence number:  003067 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LF0000X , with the licence number: F333590 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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