Healthcare Provider Details
I. General information
NPI: 1720904667
Provider Name (Legal Business Name): ALIZA WEINSTOCK CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9 VAN WINKLE RD
MONSEY NY
10952-1331
US
IV. Provider business mailing address
1045 E 24TH ST
BROOKLYN NY
11210-3639
US
V. Phone/Fax
- Phone: 347-491-3627
- Fax:
- Phone: 347-491-3627
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | 8445 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: