Provider Demographics
NPI:1760731376
Name:WEBER, YOEL
Entity Type:Individual
Prefix:
First Name:YOEL
Middle Name:
Last Name:WEBER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4910 15TH AVE
Mailing Address - Street 2:APT 2E
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-3231
Mailing Address - Country:US
Mailing Address - Phone:718-435-2085
Mailing Address - Fax:
Practice Address - Street 1:4910 15TH AVE
Practice Address - Street 2:APT 2E
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-3231
Practice Address - Country:US
Practice Address - Phone:718-435-2085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist