Provider Demographics
NPI:1386859668
Name:WEINMAN, ELISHEVA (RPA-C)
Entity Type:Individual
Prefix:MRS
First Name:ELISHEVA
Middle Name:
Last Name:WEINMAN
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:MS
Other - First Name:MILANA
Other - Middle Name:
Other - Last Name:TOKOVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPA-C
Mailing Address - Street 1:14720 69TH RD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-1732
Mailing Address - Country:US
Mailing Address - Phone:718-793-6976
Mailing Address - Fax:
Practice Address - Street 1:374 STOCKHOLM ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237-4006
Practice Address - Country:US
Practice Address - Phone:718-963-7602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006999363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical