Provider Demographics
NPI:1366466450
Name:WEINSTEIN, STEVEN SAMUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:SAMUEL
Last Name:WEINSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6815 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-1310
Mailing Address - Country:US
Mailing Address - Phone:718-520-8220
Mailing Address - Fax:718-575-9851
Practice Address - Street 1:6815 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-1310
Practice Address - Country:US
Practice Address - Phone:718-520-8220
Practice Address - Fax:718-575-9851
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2008-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY159455207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00954467Medicaid
NY00954467Medicaid
NYD91813Medicare UPIN
NY34481Medicare PIN