Provider Demographics
NPI:1477015543
Name:WEINRAUB, AMY
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:WEINRAUB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21023 BENNETT PL
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18966-5518
Mailing Address - Country:US
Mailing Address - Phone:267-400-6650
Mailing Address - Fax:
Practice Address - Street 1:545 STREET RD
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18966-3786
Practice Address - Country:US
Practice Address - Phone:267-400-6650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-05
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment