Healthcare Provider Details

I. General information

NPI: 1679483499
Provider Name (Legal Business Name): AMELIE WEILHARTER
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7721 64TH ST
GLENDALE NY
11385-6151
US

IV. Provider business mailing address

7721 64TH ST
GLENDALE NY
11385-6151
US

V. Phone/Fax

Practice location:
  • Phone: 347-686-4596
  • Fax:
Mailing address:
  • Phone: 347-686-4596
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number015367
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: