MEDICARE: BETH WEINBERG L.C.S.W.

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1184085490
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETH WEINBERG L.C.S.W.

Provider Business Mailing Address
First Line	:	PO BOX 489
Second Line	:
City	:	HIGHLAND MILLS
State	:	NY
Zip	:	10930-0489
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	375 ROUTE 32
Second Line	:
City	:	CENTRAL VALLEY
State	:	NY
Zip	:	10917-3201
Country	:	US
Telephone Number	:	845-827-6364
Fax Number	:

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

Provider Enumeration Date	:	03/14/2016
Last Update Date	:	03/14/2016

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