Provider Demographics
NPI:1558447409
Name:WEINGARTEN-ARAMS, JACQUELINE S (MD)
Entity Type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:S
Last Name:WEINGARTEN-ARAMS
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 1:48 HOMESTEAD RD
Mailing Address - Street 2:
Mailing Address - City:TENAFLY
Mailing Address - State:NJ
Mailing Address - Zip Code:07670-1109
Mailing Address - Country:US
Mailing Address - Phone:201-816-9453
Mailing Address - Fax:201-816-1968
Practice Address - Street 1:CHAM
Practice Address - Street 2:3415 BAINBRIDGE AVENUE
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467
Practice Address - Country:US
Practice Address - Phone:718-741-2440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1713312080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01209232Medicaid
G49434Medicare UPIN
364941Medicare ID - Type Unspecified