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Individual

COREY J WEINER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
545 ELMONT RD, ELMONT, NY 11003-4002
(516) 495-7129
(516) 977-2874
Mailing address
545 ELMONT RD, ELMONT, NY 11003-4002
(516) 495-7129
(516) 977-2874

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
239107
NY
2085R0202X
Diagnostic Radiology Physician
MA46748
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
05219906
NY
Enumeration date
07/12/2006
Last updated
04/25/2017
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