Provider Demographics
NPI:1609969609
Name:WEINSTEIN, KENNETH N (MD)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:N
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 1:262 CENTRAL PARK WEST
Mailing Address - Street 2:SUITE 1EE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-3512
Mailing Address - Country:US
Mailing Address - Phone:212-799-2627
Mailing Address - Fax:212-799-2643
Practice Address - Street 1:262 CENTRAL PARK WEST
Practice Address - Street 2:SUITE 1EE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-3512
Practice Address - Country:US
Practice Address - Phone:212-799-2627
Practice Address - Fax:212-799-2643
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY085858207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
2C3696OtherHEALTHNET
4279779OtherAETNA PPO
577007OtherAETNA HMO
NY00132169Medicaid
589394OtherUNITED HEALTHCARE
437831OtherEMPIRE BCBS
NP133OtherOXFORD
437831OtherEMPIRE BCBS
2C3696OtherHEALTHNET