MEDICARE: MS. GAIL WEINBERG M.A., C.C.C.-S.L.P.

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	235Z00000X	Speech-Language Pathologist	007860-1	NY

General Provider Information

NPI Number	:	1174857924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. GAIL WEINBERG M.A., C.C.C.-S.L.P.

Provider Business Mailing Address
First Line	:	85-67 HOLLIS HILLS TERRACE
Second Line	:
City	:	QUEENS VILLAGE
State	:	NY
Zip	:	11427-1346
Country	:	US
Telephone Number	:	718-468-6529
Fax Number	:	718-468-6549

Provider Business Practice Location Address
First Line	:	85-67 HOLLIS HILLS TERRACE
Second Line	:
City	:	QUEENS VILLAGE
State	:	NY
Zip	:	11427-1346
Country	:	US
Telephone Number	:	718-468-6529
Fax Number	:	718-468-6549

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

Provider Enumeration Date	:	09/28/2009
Last Update Date	:	09/28/2009

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