Provider Demographics
NPI:1821064775
Name:WEINER, HENRY L (MD)
Entity Type:Individual
Prefix:MR
First Name:HENRY
Middle Name:L
Last Name:WEINER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:252 CHAPMAN RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-5438
Mailing Address - Country:US
Mailing Address - Phone:302-366-7665
Mailing Address - Fax:302-366-1094
Practice Address - Street 1:252 CHAPMEN ROAD
Practice Address - Street 2:SUITE 150
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-1094
Practice Address - Country:US
Practice Address - Phone:302-623-1929
Practice Address - Fax:302-366-1075
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10003470207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1821064775Medicaid
DE605845C16Medicare ID - Type Unspecified
DE1821064775Medicaid