Individual
JEROME R WEINER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
325 MEETING HOUSE LN, BLDG 1 SUITE K, SOUTHAMPTON, NY 11968-5087
(631) 283-8008
(631) 283-8870
Mailing address
57 HAMPTON RD, SUITE 201, SOUTHAMPTON, NY 11968-4973
(631) 283-2430
(631) 283-7496
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
137977
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00844142
—
NY
Enumeration date
11/22/2006
Last updated
08/02/2016
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