Provider Demographics
NPI:1275985418
Name:WEINBERG, SAM
Entity Type:Individual
Prefix:
First Name:SAM
Middle Name:
Last Name:WEINBERG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2071 FLATBUSH AVE
Mailing Address - Street 2:SUITE 22
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-4340
Mailing Address - Country:US
Mailing Address - Phone:718-338-2999
Mailing Address - Fax:
Practice Address - Street 1:2115 E DIVISION ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-7817
Practice Address - Country:US
Practice Address - Phone:718-564-3070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-12
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory