Individual
KENNETH WEINBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
718 TEANECK RD, TEANECK, NJ 07666-4245
(201) 833-3913
Mailing address
476 BROADWAY, NEW YORK, NY 10013-2641
(212) 431-3395
(212) 965-8892
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25MA04897900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1997602
—
NJ
Enumeration date
07/29/2005
Last updated
05/18/2008
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