MEDICARE: REGINA 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	235Z00000X	Speech-Language Pathologist	0001331	NY

General Provider Information

NPI Number	:	1720460975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REGINA WEINER

Provider Business Mailing Address
First Line	:	555 BROADWAY
Second Line	:
City	:	DOBBS FERRY
State	:	NY
Zip	:	10522-1186
Country	:	US
Telephone Number	:	914-674-7742
Fax Number	:

Provider Business Practice Location Address
First Line	:	555 BROADWAY
Second Line	:
City	:	DOBBS FERRY
State	:	NY
Zip	:	10522-1186
Country	:	US
Telephone Number	:	914-674-7742
Fax Number	:

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

Provider Enumeration Date	:	06/24/2015
Last Update Date	:	06/24/2015

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Directions to “ REGINA WEINER ” Practice Location

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