Provider Demographics
NPI:1336351824
Name:WEINSTEIN, ELIN (PHD)
Entity Type:Individual
Prefix:DR
First Name:ELIN
Middle Name:
Last Name:WEINSTEIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:ELIN
Other - Middle Name:
Other - Last Name:FREILICH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:182-49 RADNOR ROAD
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:182-49 RADNOR ROAD
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432
Practice Address - Country:US
Practice Address - Phone:718-380-1934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007462-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01575Medicare ID - Type Unspecified