Provider Demographics
NPI:1083868046
Name:WEINBERG, ERIN ELIZABETH RYAN (CRNA, APRN)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:ELIZABETH RYAN
Last Name:WEINBERG
Suffix:
Gender:F
Credentials:CRNA, APRN
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:ELIZABETH
Other - Last Name:RYAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA, APRN
Mailing Address - Street 1:20 CARRIAGE HILL DRIVE
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405
Mailing Address - Country:US
Mailing Address - Phone:203-410-1011
Mailing Address - Fax:
Practice Address - Street 1:633 ORANGE ST
Practice Address - Street 2:APT. 2R
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-3824
Practice Address - Country:US
Practice Address - Phone:203-410-1011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-04
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT74172367500000X
CTCSP.0045256367500000X
CT004046367500000X
CT4046367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered