Provider Demographics
NPI:1669544045
Name:WEINER, ALLAN (BS PHARMACY)
Entity type:Individual
Prefix:MR
First Name:ALLAN
Middle Name:
Last Name:WEINER
Suffix:
Gender:M
Credentials:BS PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3355 COLONY DRIVE
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510
Mailing Address - Country:US
Mailing Address - Phone:516-868-5674
Mailing Address - Fax:
Practice Address - Street 1:353 NEWBRIDGE RD
Practice Address - Street 2:MEADOW DRUGS
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-4121
Practice Address - Country:US
Practice Address - Phone:516-785-0120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0264141183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist