MEDICARE: MIRIAM WEINBERGER

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	7528265UPD	NY

General Provider Information

NPI Number	:	1598048514
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIRIAM WEINBERGER

Provider Business Mailing Address
First Line	:	1390 EAST 34TH STREET
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1390 EAST 34TH STREET
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210
Country	:	US
Telephone Number	:	718-284-3110
Fax Number	:

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

Provider Enumeration Date	:	09/26/2011
Last Update Date	:	09/26/2011

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Directions to “ MIRIAM WEINBERGER ” Practice Location

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