Provider Demographics
NPI:1033266531
Name:WEINER, HOWARD FRANK (PHD, APRN)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:FRANK
Last Name:WEINER
Suffix:
Gender:M
Credentials:PHD, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-1400
Mailing Address - Country:US
Mailing Address - Phone:978-750-8751
Mailing Address - Fax:978-750-8758
Practice Address - Street 1:130 CENTRE ST
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-1400
Practice Address - Country:US
Practice Address - Phone:978-750-8751
Practice Address - Fax:978-750-8758
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4886103T00000X
MAPN0853363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW04629OtherBLUE CROSS BLUE SHIELD
MAW04629Medicare ID - Type Unspecified