Provider Demographics
NPI:1801865902
Name:WEINGARTEN, MARVIN J (MD)
Entity Type:Individual
Prefix:DR
First Name:MARVIN
Middle Name:J
Last Name:WEINGARTEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:320 ROBINSON AVE
Mailing Address - Street 2:C/O ORANGE RADIOLOGY ASSOCIATES, P.C.
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-3353
Mailing Address - Country:US
Mailing Address - Phone:845-565-1989
Mailing Address - Fax:845-863-0072
Practice Address - Street 1:320 ROBINSON AVE
Practice Address - Street 2:C/O ORANGE RADIOLOGY ASSOCIATES, PC
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-3353
Practice Address - Country:US
Practice Address - Phone:845-565-1989
Practice Address - Fax:845-863-0072
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1450842085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY300095524OtherRAILROAD MEDICARE
NY300104613OtherRAILROAD MEDICARE
NY300104614OtherRAILROAD MEDICARE
NY300104619OtherRAILROAD MEDICARE
NY300107699OtherRAILROAD MEDICARE
NY300107700OtherRAILROAD MEDICARE
NY300104616OtherRAILROAD MEDICARE
NY300104617OtherRAILROAD MEDICARE
NY00919737Medicaid
NY300048075OtherRAILROAD MEDICARE
NY300104618OtherRAILROAD MEDICARE
NY300107699OtherRAILROAD MEDICARE
NY300095524OtherRAILROAD MEDICARE