Individual
DR. LISA R WEINSTOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
79 CHESTNUT ST, RIDGEWOOD, NJ 07450-2563
(201) 444-4484
(201) 444-4148
Mailing address
79 CHESTNUT ST, RIDGEWOOD, NJ 07450-2563
(201) 444-4484
(201) 444-4148
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
195211
NY
2085R0202X
Diagnostic Radiology Physician
25MA05610100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
195211
NYS LICENSE
NY
Enumeration date
08/14/2006
Last updated
03/07/2023
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