Provider Demographics
NPI:1932653748
Name:WEINTRAUB, TALIA
Entity Type:Individual
Prefix:
First Name:TALIA
Middle Name:
Last Name:WEINTRAUB
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 1:435 CENTRAL PARK W
Mailing Address - Street 2:APARTMENT 1U
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-4377
Mailing Address - Country:US
Mailing Address - Phone:818-530-3104
Mailing Address - Fax:
Practice Address - Street 1:435 CENTRAL PARK W
Practice Address - Street 2:APARTMENT 1U
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-4377
Practice Address - Country:US
Practice Address - Phone:818-530-3104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-09
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist