Provider Demographics
NPI:1336263268
Name:WEINER, AMRAM (DC)
Entity Type:Individual
Prefix:DR
First Name:AMRAM
Middle Name:
Last Name:WEINER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:304 E 65TH ST
Mailing Address - Street 2:SUITE LL1
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-6797
Mailing Address - Country:US
Mailing Address - Phone:212-249-3884
Mailing Address - Fax:212-639-9409
Practice Address - Street 1:304 E 65TH ST
Practice Address - Street 2:SUITE LL1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-6797
Practice Address - Country:US
Practice Address - Phone:212-249-3884
Practice Address - Fax:212-639-9409
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-17
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYXOO3659-1111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX23861Medicare PIN