Individual
DR. FREDERIC WEINBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5645 MAIN ST, RM-M204, FLUSHING, NY 11355-5045
(718) 445-0220
(718) 939-1167
Mailing address
5645 MAIN ST, RM-M204, FLUSHING, NY 11355-5045
(718) 445-0220
(718) 939-1167
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
137911
NY
2086S0102X
Surgical Critical Care Physician
137911
NY
2086S0129X
Vascular Surgery Physician
137911
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00648522
—
NY
Enumeration date
05/30/2006
Last updated
03/06/2008
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