Provider Demographics
NPI:1013244185
Name:WEININGER, RICHARD B (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:B
Last Name:WEININGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:P.O BOX 737
Mailing Address - Street 2:125 MILLBROOK RD.
Mailing Address - City:CLAVERACK
Mailing Address - State:NY
Mailing Address - Zip Code:12513
Mailing Address - Country:US
Mailing Address - Phone:914-388-0800
Mailing Address - Fax:518-751-1531
Practice Address - Street 1:125 MILLBROOK ROAD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534
Practice Address - Country:US
Practice Address - Phone:914-388-0800
Practice Address - Fax:518-751-1531
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-11
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY117078207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY117078OtherSTATE LICENSE
NYAW9623756OtherDEA