Provider Demographics
NPI:1669419131
Name:WEINSTEIN, MARINA (RPA-C)
Entity type:Individual
Prefix:MRS
First Name:MARINA
Middle Name:
Last Name:WEINSTEIN
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2302 STUART ST
Mailing Address - Street 2:APT 1H
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-5814
Mailing Address - Country:US
Mailing Address - Phone:718-975-3276
Mailing Address - Fax:
Practice Address - Street 1:2044 OCEAN AVE
Practice Address - Street 2:SUITE A7
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-7328
Practice Address - Country:US
Practice Address - Phone:718-998-5556
Practice Address - Fax:718-998-5566
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009196-1363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5394L1Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER