Basic Information
| Provider Information | |||||||||
| NPI: | 1538580352 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WEINSTEIN | ||||||||
| FirstName: | ERICA | ||||||||
| MiddleName: | FAITH | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHARMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 114 BEVERLEY ROAD | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112183150 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5163528548 | ||||||||
| FaxNumber: | 7184377808 | ||||||||
| Practice Location | |||||||||
| Address1: | 114 BEVERLEY RD | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112183914 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5163528548 | ||||||||
| FaxNumber: | 7184377808 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/20/2013 | ||||||||
| LastUpdateDate: | 12/20/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 058512 | NY | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.