Provider Demographics
NPI:1245268739
Name:WEINHEIMER, DARREN J (DPM)
Entity type:Individual
Prefix:
First Name:DARREN
Middle Name:J
Last Name:WEINHEIMER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13905-4219
Mailing Address - Country:US
Mailing Address - Phone:607-734-9539
Mailing Address - Fax:607-723-0715
Practice Address - Street 1:134 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13905-4219
Practice Address - Country:US
Practice Address - Phone:607-734-9539
Practice Address - Fax:607-723-0715
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005460213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01897878Medicaid
NYBB0680Medicare ID - Type Unspecified
NY01897878Medicaid