Provider Demographics
NPI:1609056423
Name:WEINSTEIN-SHAMA, CHERYL SUE (RPA-C)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:SUE
Last Name:WEINSTEIN-SHAMA
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4802 10TH AVE
Mailing Address - Street 2:MAIMONIDES MEDICAL CENTER-INTERVENTIONAL RADIOLOGY DEPT
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-2916
Mailing Address - Country:US
Mailing Address - Phone:718-283-7125
Mailing Address - Fax:718-635-6071
Practice Address - Street 1:4802 10TH AVE
Practice Address - Street 2:MAIMONIDES MEDICAL CENTER-INTERVENTIONAL RADIOLOGY DEPT
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-2916
Practice Address - Country:US
Practice Address - Phone:718-283-7125
Practice Address - Fax:718-635-6071
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-08
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009905363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant