Provider Demographics
NPI:1316579592
Name:WEINMAN, LONI LEIGH (NP)
Entity Type:Individual
Prefix:
First Name:LONI
Middle Name:LEIGH
Last Name:WEINMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 TOWNSEND AVE
Mailing Address - Street 2:
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960-4818
Mailing Address - Country:US
Mailing Address - Phone:201-919-5179
Mailing Address - Fax:
Practice Address - Street 1:12 STUDIO ARC
Practice Address - Street 2:
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-2631
Practice Address - Country:US
Practice Address - Phone:914-202-0135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-06
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY309210363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner