Provider Demographics
NPI:1881703478
Name:WEINGARTEN, NACHUM (PA)
Entity type:Individual
Prefix:MR
First Name:NACHUM
Middle Name:
Last Name:WEINGARTEN
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:953 49TH ST
Mailing Address - Street 2:SUITE 511
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-2923
Mailing Address - Country:US
Mailing Address - Phone:718-283-8380
Mailing Address - Fax:718-283-7884
Practice Address - Street 1:1ST AVE, 16TH STREET
Practice Address - Street 2:RADIOLOGY DEPARTMENT, INTERVENTIONAL DIVISION
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:212-420-2546
Practice Address - Fax:212-420-2557
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY007362363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02374830Medicaid
NYP46486Medicare UPIN
NY4F9901Medicare ID - Type Unspecified