Basic Information
| Provider Information | |||||||||
| NPI: | 1184058489 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ERICA WEINSTEIN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1983 MARCUS AVE | ||||||||
| Address2: | SUITE C100 | ||||||||
| City: | NEW HYDE PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 110422000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5163528548 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1983 MARCUS AVE | ||||||||
| Address2: | SUITE C100 | ||||||||
| City: | NEW HYDE PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 110422000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5163528548 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2013 | ||||||||
| LastUpdateDate: | 10/02/2013 | ||||||||
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| AuthorizedOfficialLastName: | WEINSTEIN | ||||||||
| AuthorizedOfficialFirstName: | WEINSTEIN | ||||||||
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| AuthorizedOfficialTitleorPosition: | DISTRICT PHARMACY SUPERVISOR | ||||||||
| AuthorizedOfficialTelephone: | 7184377802 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3336C0003X | 058512 | NY | Y | Suppliers | Pharmacy | Community/Retail Pharmacy |
No ID Information.