Healthcare Provider Details

I. General information

NPI: 1578629911
Provider Name (Legal Business Name): MARGARET WEBER AUDIOLOGIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 PELHAM PKWY S
BRONX NY
10461-1138
US

IV. Provider business mailing address

141 JORALEMON ST
BROOKLYN NY
11201-4071
US

V. Phone/Fax

Practice location:
  • Phone: 718-918-3060
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number001142
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: