Provider Demographics
NPI:1083474209
Name:WEINTRAUB, ANNA REBECCA (PMHNP-BC)
Entity Type:Individual
Prefix:MS
First Name:ANNA
Middle Name:REBECCA
Last Name:WEINTRAUB
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 E 39TH ST STE 902
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-0468
Mailing Address - Country:US
Mailing Address - Phone:646-592-0869
Mailing Address - Fax:
Practice Address - Street 1:6 E 39TH ST STE 902
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-0468
Practice Address - Country:US
Practice Address - Phone:646-592-0869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY405743363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health