MEDICARE: MS. MARILYN WEINGARD LCSW

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	101YM0800X	Mental Health Counselor	R037508-1	NY

General Provider Information

NPI Number	:	1275775918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARILYN WEINGARD LCSW

Provider Business Mailing Address
First Line	:	2727 LINCOLN BLVD
Second Line	:
City	:	MERRICK
State	:	NY
Zip	:	11566-4772
Country	:	US
Telephone Number	:	516-546-2824
Fax Number	:	516-546-2824

Provider Business Practice Location Address
First Line	:	2727 LINCOLN BLVD
Second Line	:
City	:	MERRICK
State	:	NY
Zip	:	11566-4772
Country	:	US
Telephone Number	:	516-546-2824
Fax Number	:	516-546-2824

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

Provider Enumeration Date	:	03/26/2009
Last Update Date	:	03/26/2009

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