Provider Demographics
NPI:1457682940
Name:WEINGARTEN, AMANDA (CNM)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:WEINGARTEN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 E 57TH ST
Mailing Address - Street 2:APARTMENT 16A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-2811
Mailing Address - Country:US
Mailing Address - Phone:516-680-1437
Mailing Address - Fax:
Practice Address - Street 1:200 W 57TH ST
Practice Address - Street 2:SUITE 1300
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-3211
Practice Address - Country:US
Practice Address - Phone:212-603-4160
Practice Address - Fax:212-603-4166
Is Sole Proprietor?:No
Enumeration Date:2010-01-22
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY602190163W00000X
NY001363367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse