Provider Demographics
NPI:1720083710
Name:WEINREB, BARRY D (MD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:D
Last Name:WEINREB
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 1:261 JAMES ST
Mailing Address - Street 2:STE 1D
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960
Mailing Address - Country:US
Mailing Address - Phone:973-267-3646
Mailing Address - Fax:973-335-3319
Practice Address - Street 1:261 JAMES ST
Practice Address - Street 2:STE 1D
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960
Practice Address - Country:US
Practice Address - Phone:973-267-3646
Practice Address - Fax:973-335-3319
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04987300174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ415359Medicare ID - Type Unspecified
E23746Medicare UPIN