Healthcare Provider Details

I. General information

NPI: 1215856562
Provider Name (Legal Business Name): ESTY WEINGARTEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

845 STATE ROUTE 17M
MONROE NY
10950-1606
US

IV. Provider business mailing address

4 MEZABISH PL UNIT 312
MONROE NY
10950-5418
US

V. Phone/Fax

Practice location:
  • Phone: 845-425-5252
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number132265
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: