Provider Demographics
NPI:1366477507
Name:WEIN, BARRY (DO)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:
Last Name:WEIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 157
Mailing Address - Street 2:
Mailing Address - City:BOHEMIA
Mailing Address - State:NY
Mailing Address - Zip Code:11716-0157
Mailing Address - Country:US
Mailing Address - Phone:516-234-0018
Mailing Address - Fax:
Practice Address - Street 1:4155 VETERANS MEMORIAL HWY STE 5
Practice Address - Street 2:
Practice Address - City:RONKONKOMA
Practice Address - State:NY
Practice Address - Zip Code:11779-6063
Practice Address - Country:US
Practice Address - Phone:631-412-4800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY188150207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine