Provider Demographics
NPI:1609443522
Name:WEINBERGER, RANDI LEIGH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:RANDI
Middle Name:LEIGH
Last Name:WEINBERGER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 TRESSER BLVD APT 606
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06901-5306
Mailing Address - Country:US
Mailing Address - Phone:516-851-8016
Mailing Address - Fax:
Practice Address - Street 1:427 BEDFORD RD STE 130
Practice Address - Street 2:
Practice Address - City:PLEASANTVILLE
Practice Address - State:NY
Practice Address - Zip Code:10570-3035
Practice Address - Country:US
Practice Address - Phone:914-488-4343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-09
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025126103TC0700X
CT4554103TC0700X
103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical