Provider Demographics
NPI:1639180151
Name:WEINTRAUB, SHARON LYNN (MD)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:LYNN
Last Name:WEINTRAUB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 GRAND STREET
Mailing Address - Street 2:THE HOSPITAL OF CENTRAL CONNECTICUT, DEPT OF SURGERY
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06052
Mailing Address - Country:US
Mailing Address - Phone:860-224-5513
Mailing Address - Fax:860-224-5713
Practice Address - Street 1:100 GRAND STREET
Practice Address - Street 2:THE HOSPITAL OF CENTRAL CONNECTICUT
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06052
Practice Address - Country:US
Practice Address - Phone:860-224-5513
Practice Address - Fax:860-224-5713
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0514172086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1186988Medicaid
H43976Medicare UPIN
LA1186988Medicaid