Provider Demographics
NPI:1659597854
Name:WEINSTEIN, JOAN TOSHIMI (PA-C)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:TOSHIMI
Last Name:WEINSTEIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JOAN
Other - Middle Name:TOSHIMI
Other - Last Name:RUBIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:225 MILLBURN AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:MILLBURN
Mailing Address - State:NJ
Mailing Address - Zip Code:07041-1737
Mailing Address - Country:US
Mailing Address - Phone:973-218-1990
Mailing Address - Fax:
Practice Address - Street 1:225 MILLBURN AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1737
Practice Address - Country:US
Practice Address - Phone:973-218-1990
Practice Address - Fax:973-218-1993
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00178800363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
119262XH5Medicare PIN