MEDICARE: TANYA WEEKES LMSW

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	104100000X	Social Worker	085701-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	085701-1	OTHER	NY	NEW YORK EDUCATION DEPARTMENT

General Provider Information

NPI Number	:	1326780412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TANYA WEEKES LMSW

Provider Business Mailing Address
First Line	:	2151 HARING ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-5114
Country	:	US
Telephone Number	:	917-214-7498
Fax Number	:

Provider Business Practice Location Address
First Line	:	2151 HARING ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-5114
Country	:	US
Telephone Number	:	917-214-7498
Fax Number	:

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

Provider Enumeration Date	:	04/10/2022
Last Update Date	:	04/10/2022

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