Provider Demographics
NPI:1518070689
Name:WEINSTEIN, ZOE A (MD)
Entity Type:Individual
Prefix:MS
First Name:ZOE
Middle Name:A
Last Name:WEINSTEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 MARY'S AVE, SUITE 203
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401
Mailing Address - Country:US
Mailing Address - Phone:845-383-1759
Mailing Address - Fax:845-383-1782
Practice Address - Street 1:368 BROADWAY STE 101
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-5158
Practice Address - Country:US
Practice Address - Phone:845-383-1759
Practice Address - Fax:845-383-1782
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY217785208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02156807Medicaid
NYH40162Medicare UPIN
NY02156807Medicaid
H40162Medicare UPIN
3G0451Medicare PIN
NY02156807Medicaid