Provider Demographics
NPI:1871018606
Name:WEITZ, BRITTNEY LYN
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:LYN
Last Name:WEITZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 SUPERIOR ST
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11776-4365
Mailing Address - Country:US
Mailing Address - Phone:631-356-3641
Mailing Address - Fax:
Practice Address - Street 1:51 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:LAKE RONKONKOMA
Practice Address - State:NY
Practice Address - Zip Code:11779-2231
Practice Address - Country:US
Practice Address - Phone:631-471-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-14
Last Update Date:2023-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist