Individual
DR. IVAN GREGORY WEINER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
468 S GANNON AVE, STATEN ISLAND, NY 10314-7610
(718) 556-5360
(718) 477-5739
Mailing address
PO BOX 140386, STATEN ISLAND, NY 10314-0386
(718) 556-5360
(718) 477-5739
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
009656
NY
Other
Enumeration date
02/14/2007
Last updated
01/20/2011
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