Provider Demographics
NPI:1043419161
Name:WEI, HENRY (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:
Last Name:WEI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:HENRY
Other - Middle Name:GEORGE
Other - Last Name:WEI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1 CHATSWORTH AVE #89
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538
Mailing Address - Country:US
Mailing Address - Phone:646-741-2500
Mailing Address - Fax:646-681-3999
Practice Address - Street 1:1 CHATSWORTH AVE
Practice Address - Street 2:#89
Practice Address - City:LARCHMONT
Practice Address - State:NY
Practice Address - Zip Code:10538
Practice Address - Country:US
Practice Address - Phone:646-751-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYA231721171100000X
NY231721208D00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No171100000XOther Service ProvidersAcupuncturist
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY231721OtherMEDICAL LICENSE