Provider Demographics
NPI:1841567559
Name:DEBRA WEINSTOCK LLC
Entity Type:Organization
Organization Name:DEBRA WEINSTOCK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:SHARON
Authorized Official - Last Name:BECKER WEINSTOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-871-9515
Mailing Address - Street 1:131 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-4322
Mailing Address - Country:US
Mailing Address - Phone:201-871-9515
Mailing Address - Fax:
Practice Address - Street 1:131 MADISON AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-4322
Practice Address - Country:US
Practice Address - Phone:201-871-9515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-23
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016307225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty