Provider Demographics
NPI:1366684482
Name:WEINSTEIN, CRAIG LINDON (LAC, LMT)
Entity Type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:LINDON
Last Name:WEINSTEIN
Suffix:
Gender:M
Credentials:LAC, LMT
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 217
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-0217
Mailing Address - Country:US
Mailing Address - Phone:516-248-7762
Mailing Address - Fax:
Practice Address - Street 1:153 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:WILLISTON PARK
Practice Address - State:NY
Practice Address - Zip Code:11596-1700
Practice Address - Country:US
Practice Address - Phone:516-248-7762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-03
Last Update Date:2009-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003129171100000X
NY017008225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY287710OtherVYTRA/HIP
NYP3662196OtherOXFORD HEALTH PLANS