Provider Demographics
NPI:1033274121
Name:WEINER, REBBECCA JOY (OTR)
Entity Type:Individual
Prefix:
First Name:REBBECCA
Middle Name:JOY
Last Name:WEINER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2679 REBECCA ST
Mailing Address - Street 2:
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-5415
Mailing Address - Country:US
Mailing Address - Phone:516-705-4427
Mailing Address - Fax:
Practice Address - Street 1:2108 MERRICK MALL
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-3626
Practice Address - Country:US
Practice Address - Phone:516-868-5302
Practice Address - Fax:516-546-7681
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2013-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012064-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist