MEDICARE: CAROL FRANCINE WEINER

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	1041C0700X	Clinical Social Worker	R050303	NY

General Provider Information

NPI Number	:	1609292093
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL FRANCINE WEINER

Provider Business Mailing Address
First Line	:	24916 UNION TPKE
Second Line	:
City	:	BELLEROSE
State	:	NY
Zip	:	11426-1827
Country	:	US
Telephone Number	:	718-347-1536
Fax Number	:

Provider Business Practice Location Address
First Line	:	304 E 65TH ST
Second Line	:	LL1
City	:	NEW YORK
State	:	NY
Zip	:	10065-6797
Country	:	US
Telephone Number	:	212-249-3884
Fax Number	:

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

Provider Enumeration Date	:	03/10/2014
Last Update Date	:	03/10/2014

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Directions to “ CAROL FRANCINE WEINER ” Practice Location

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