Healthcare Provider Details

I. General information

NPI: 1154667731
Provider Name (Legal Business Name): DEBORAH WEINBERGER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/31/2012
Last Update Date: 02/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 WASHINGTON AVE
SUFFERN NY
10901-6026
US

IV. Provider business mailing address

11 JOSHUA CT
MONSEY NY
10952-3640
US

V. Phone/Fax

Practice location:
  • Phone: 845-357-4500
  • Fax: 845-357-5039
Mailing address:
  • Phone: 224-436-4003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number340335
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number659854
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: