Provider Demographics
NPI:1992020473
Name:WEINSTEIN, SAM (RPH)
Entity Type:Individual
Prefix:MR
First Name:SAM
Middle Name:
Last Name:WEINSTEIN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-1503
Mailing Address - Country:US
Mailing Address - Phone:212-752-5151
Mailing Address - Fax:212-308-1775
Practice Address - Street 1:901 2ND AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-1503
Practice Address - Country:US
Practice Address - Phone:212-752-5151
Practice Address - Fax:212-308-1775
Is Sole Proprietor?:No
Enumeration Date:2010-03-29
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY31093183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist