Provider Demographics
NPI:1295742526
Name:WEINGART, SCOTT D (MD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:D
Last Name:WEINGART
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:STONY BROOK UNIVERSITY HOSP
Mailing Address - Street 2:HSC, LEVEL 4, ROOM 080
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-0001
Mailing Address - Country:US
Mailing Address - Phone:206-338-5593
Mailing Address - Fax:206-338-5593
Practice Address - Street 1:STONY BROOK UNIVERSITY HOSP
Practice Address - Street 2:HSC, LEVEL 4, ROOM 080
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-0001
Practice Address - Country:US
Practice Address - Phone:206-338-5593
Practice Address - Fax:206-338-5593
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY221975207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02677874Medicaid
NYI40286Medicare UPIN
NY02677874Medicaid