Individual
AVI WEINER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
47 OAK ST, STE 110, STAMFORD, CT 06905-5320
(203) 356-1450
(203) 323-8875
Mailing address
47 OAK ST, STE 110, STAMFORD, CT 06905-5320
(203) 356-1450
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
027452
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
027452
LICENSE
CT
Enumeration date
10/17/2006
Last updated
12/19/2019
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