Provider Demographics
NPI:1083716104
Name:WEINSTEIN, CRAIG (MD)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:
Last Name:WEINSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7236
Mailing Address - Street 2:
Mailing Address - City:E BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-7236
Mailing Address - Country:US
Mailing Address - Phone:201-342-1205
Mailing Address - Fax:201-342-1259
Practice Address - Street 1:561 CRANBURY RD
Practice Address - Street 2:
Practice Address - City:E BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5400
Practice Address - Country:US
Practice Address - Phone:201-342-1205
Practice Address - Fax:201-342-1259
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA37011174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
APPLYMedicare ID - Type Unspecified