Provider Demographics
NPI:1205077492
Name:WENDY L WEINSTEIN MD PC
Entity type:Organization
Organization Name:WENDY L WEINSTEIN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:L
Authorized Official - Last Name:WEINSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-479-5249
Mailing Address - Street 1:651 DELAWARE AVE
Mailing Address - Street 2:STE 201
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14202-1051
Mailing Address - Country:US
Mailing Address - Phone:716-362-1210
Mailing Address - Fax:716-362-1280
Practice Address - Street 1:651 DELAWARE AVE
Practice Address - Street 2:STE 201
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14202-1051
Practice Address - Country:US
Practice Address - Phone:716-362-1210
Practice Address - Fax:716-362-1280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-17
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01933935Medicaid
NY1510670OtherINDEPENDENT HEALTH
NY01933935Medicaid