Provider Demographics
NPI:1710008818
Name:WEINBERGER, JOEL (PHD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:WEINBERGER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SOUTH ST
Mailing Address - Street 2:DERNER INSTITUTE ADELPHI UNIVERSITY BOX 701
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530
Mailing Address - Country:US
Mailing Address - Phone:516-877-4816
Mailing Address - Fax:516-877-4805
Practice Address - Street 1:1 SOUTH ST
Practice Address - Street 2:DERNER INSTITUTE, ADELPHI UNIVERSITY, BOX 701
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-4801
Practice Address - Country:US
Practice Address - Phone:516-877-4816
Practice Address - Fax:516-877-4805
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1008076-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical