MEDICARE: SARA WEIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224Z00000X	Occupational Therapy Assistant

General Provider Information

NPI Number	:	1073967634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA WEIN

Provider Business Mailing Address
First Line	:	1893 NEW YORK AVE APT A
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-4136
Country	:	US
Telephone Number	:	845-499-0376
Fax Number	:

Provider Business Practice Location Address
First Line	:	1893 NEW YORK AVE APT A
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-4136
Country	:	US
Telephone Number	:	845-499-0376
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2016
Last Update Date	:	04/20/2016

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Directions to “ SARA WEIN ” Practice Location

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