Provider Demographics
NPI:1346310349
Name:WEINER, ALISON LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:ALISON
Middle Name:LYNN
Last Name:WEINER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 HILLSIDE AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-2129
Mailing Address - Country:US
Mailing Address - Phone:973-655-0012
Mailing Address - Fax:973-655-0010
Practice Address - Street 1:8 HILLSIDE AVE STE 201
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-2129
Practice Address - Country:US
Practice Address - Phone:973-655-0012
Practice Address - Fax:973-655-0010
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA053790002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE60636Medicare UPIN
NJWE633275Medicare ID - Type Unspecified