Provider Demographics
NPI:1578850624
Name:WEINSTEIN, JOEL D (MD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:D
Last Name:WEINSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 BOOTH AVE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-1903
Mailing Address - Country:US
Mailing Address - Phone:201-567-4746
Mailing Address - Fax:201-567-4746
Practice Address - Street 1:153 BOOTH AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-1903
Practice Address - Country:US
Practice Address - Phone:201-567-4746
Practice Address - Fax:201-567-4746
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-08
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02333000207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
$$$$$$$$$AMedicare UPIN