Provider Demographics
NPI:1568409803
Name:WEG, IRA LESTER (MD)
Entity Type:Individual
Prefix:DR
First Name:IRA
Middle Name:LESTER
Last Name:WEG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:158 HEMPSTEAD AVE
Mailing Address - Street 2:
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-1605
Mailing Address - Country:US
Mailing Address - Phone:516-593-3541
Mailing Address - Fax:516-599-8307
Practice Address - Street 1:158 HEMPSTEAD AVE
Practice Address - Street 2:
Practice Address - City:LYNBROOK
Practice Address - State:NY
Practice Address - Zip Code:11563-1605
Practice Address - Country:US
Practice Address - Phone:516-593-3541
Practice Address - Fax:516-599-8307
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY135190207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
E43093Medicare UPIN