Provider Demographics
NPI:1679523484
Name:WEINSTEIN, WENDY (MD)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:
Last Name:WEINSTEIN
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 1:651 DELAWARE AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14202-1051
Mailing Address - Country:US
Mailing Address - Phone:716-362-1210
Mailing Address - Fax:716-362-1280
Practice Address - Street 1:ELM AND CARLTON ST.
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14263-0001
Practice Address - Country:US
Practice Address - Phone:716-845-2300
Practice Address - Fax:716-845-3549
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY204528-12084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01933935Medicaid
NY1510670OtherIHA
NY00020525102OtherUNIVERA
NY000525561003OtherBLUE CROSS BLUE SHIELD
NY00020525102OtherUNIVERA
NYJ400003399Medicare PIN