MEDICARE: DR. SARTON BRODIE WEINRAUB PH.D.

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	103T00000X	Psychologist	016243	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P3587857	OTHER	NY	OXFORD HEALTH PLANS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083617518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARTON BRODIE WEINRAUB PH.D.

Provider Business Mailing Address
First Line	:	439 E 9TH ST
Second Line	:	APT 6
City	:	NEW YORK
State	:	NY
Zip	:	10009-4938
Country	:	US
Telephone Number	:	212-673-8790
Fax Number	:	212-208-2955

Provider Business Practice Location Address
First Line	:	439 E 9TH ST
Second Line	:	APT 6
City	:	NEW YORK
State	:	NY
Zip	:	10009-4938
Country	:	US
Telephone Number	:	212-673-8790
Fax Number	:	212-208-2955

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

Provider Enumeration Date	:	05/30/2005
Last Update Date	:	07/08/2007

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