Provider Demographics
NPI:1497981534
Name:WINZELBERG, PENINA (MAOTR/L)
Entity Type:Individual
Prefix:
First Name:PENINA
Middle Name:
Last Name:WINZELBERG
Suffix:
Gender:F
Credentials:MAOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1532 E 36TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-3416
Mailing Address - Country:US
Mailing Address - Phone:718-377-2949
Mailing Address - Fax:
Practice Address - Street 1:1532 E 36TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-3416
Practice Address - Country:US
Practice Address - Phone:718-377-2949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013462225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics