Provider Demographics
NPI:1831577170
Name:WEINGARTEN, SERGIO L (RN)
Entity type:Individual
Prefix:
First Name:SERGIO
Middle Name:L
Last Name:WEINGARTEN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2130 1ST AVE
Mailing Address - Street 2:APT 1708
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-3321
Mailing Address - Country:US
Mailing Address - Phone:914-879-5757
Mailing Address - Fax:
Practice Address - Street 1:2130 1ST AVE
Practice Address - Street 2:APT 1708
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-3321
Practice Address - Country:US
Practice Address - Phone:914-879-5757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-06
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY690380163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse