Provider Demographics
NPI:1972772176
Name:WEINSTEIN, LENNY (DO)
Entity Type:Individual
Prefix:DR
First Name:LENNY
Middle Name:
Last Name:WEINSTEIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-8301
Mailing Address - Country:US
Mailing Address - Phone:631-376-6075
Mailing Address - Fax:631-376-6091
Practice Address - Street 1:40 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-8301
Practice Address - Country:US
Practice Address - Phone:631-376-6075
Practice Address - Fax:631-376-6091
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-21
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY240664207RI0200X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty