Provider Demographics
NPI:1295052264
Name:WEINBERG, BENJAMIN DAVID (MD, MA, FACR)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:DAVID
Last Name:WEINBERG
Suffix:
Gender:M
Credentials:MD, MA, FACR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 191625
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-1625
Mailing Address - Country:US
Mailing Address - Phone:787-621-5555
Mailing Address - Fax:787-621-5564
Practice Address - Street 1:1785 CARR 21 STE 95
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-3399
Practice Address - Country:US
Practice Address - Phone:787-621-5555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-29
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2014-024892085R0001X, 2085R0001X
PR213312085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty