Provider Demographics
NPI:1174857924
Name:WEINBERG, GAIL (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:GAIL
Middle Name:
Last Name:WEINBERG
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85-67 HOLLIS HILLS TERRACE
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11427-1346
Mailing Address - Country:US
Mailing Address - Phone:718-468-6529
Mailing Address - Fax:718-468-6549
Practice Address - Street 1:85-67 HOLLIS HILLS TERRACE
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11427-1346
Practice Address - Country:US
Practice Address - Phone:718-468-6529
Practice Address - Fax:718-468-6549
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-28
Last Update Date:2009-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007860-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist