Provider Demographics
NPI:1639136500
Name:WEINSTEIN, BARRY ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:ALAN
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 1:1445 MAPLE RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-3562
Mailing Address - Country:US
Mailing Address - Phone:716-634-7470
Mailing Address - Fax:716-634-0592
Practice Address - Street 1:1445 MAPLE RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-3562
Practice Address - Country:US
Practice Address - Phone:716-634-7470
Practice Address - Fax:716-634-0592
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY106114207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYD72743Medicare UPIN
NY062421Medicare ID - Type Unspecified