Provider Demographics
NPI:1003050766
Name:WERZBERGER, MARTIN N (MS CCC-SLP TSHH)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:N
Last Name:WERZBERGER
Suffix:
Gender:M
Credentials:MS CCC-SLP TSHH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 ROSS ST APT 3F
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-7644
Mailing Address - Country:US
Mailing Address - Phone:718-384-4313
Mailing Address - Fax:
Practice Address - Street 1:80 ROSS ST APT 3F
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-7644
Practice Address - Country:US
Practice Address - Phone:718-384-4313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-26
Last Update Date:2009-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017941235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist