Provider Demographics
NPI:1093723918
Name:HAROLD GOLDBAN GARY WEINBERG DDS
Entity Type:Organization
Organization Name:HAROLD GOLDBAN GARY WEINBERG DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:WEINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:516-536-5111
Mailing Address - Street 1:132 N PARK AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-4107
Mailing Address - Country:US
Mailing Address - Phone:516-536-5111
Mailing Address - Fax:516-536-5159
Practice Address - Street 1:132 N PARK AVE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-4107
Practice Address - Country:US
Practice Address - Phone:516-536-5111
Practice Address - Fax:516-536-5159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0227761223E0200X
NY0247111223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty