Individual
AMANDA R WEINBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
475 SEAVIEW AVE, STATEN ISLAND, NY 10305-3436
(718) 226-9000
Mailing address
107 93RD ST, BROOKLYN, NY 11209-6201
(347) 416-0661
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/06/2020
Last updated
07/31/2020
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