Provider Demographics
NPI:1598713752
Name:WEINROTH, HEIDI J (MD)
Entity Type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:J
Last Name:WEINROTH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:HEIDI
Other - Middle Name:J
Other - Last Name:FLEISHMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3 COOPER PLZ
Mailing Address - Street 2:SUITE 500
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1438
Mailing Address - Country:US
Mailing Address - Phone:856-342-2000
Mailing Address - Fax:
Practice Address - Street 1:110 MARTER AVE
Practice Address - Street 2:SUITE 503
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-3124
Practice Address - Country:US
Practice Address - Phone:856-608-8840
Practice Address - Fax:856-722-1898
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06484800208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
077356 SK3Medicare PIN