Provider Demographics
NPI:1972524759
Name:WEINTRAUB, MELISSA (MD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
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 1:110 S BEDFORD RD
Mailing Address - Street 2:CAREMOUNT MEDICAL, PC
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3446
Mailing Address - Country:US
Mailing Address - Phone:914-241-1050
Mailing Address - Fax:914-455-2980
Practice Address - Street 1:360 N BEDFORD RD
Practice Address - Street 2:CAREMOUNT MEDICAL, PC
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-1143
Practice Address - Country:US
Practice Address - Phone:914-302-8060
Practice Address - Fax:914-455-2980
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY198305207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
796338OtherMVP HEALTH PLAN
NY01717835Medicaid
060816000002OtherFIDELIS CARE OF NY
5C4632OtherHEALTHNET PIN #
P3680133OtherOXFORD HEALTH PLAN PIN#
1253030OtherAETNA HMO
2406Q1OtherBCBS
5127457OtherAETNA PPO
10037134OtherCDPHP
796338OtherMVP
5127457OtherAETNA PPO
NY01717835Medicaid