Provider Demographics
NPI:1972632966
Name:WEINTRAUB, CECILY G (PHD)
Entity Type:Individual
Prefix:DR
First Name:CECILY
Middle Name:G
Last Name:WEINTRAUB
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 HEMPSTEAD AVE
Mailing Address - Street 2:
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-1605
Mailing Address - Country:US
Mailing Address - Phone:516-764-9726
Mailing Address - Fax:516-764-5230
Practice Address - Street 1:164 HEMPSTEAD AVE
Practice Address - Street 2:
Practice Address - City:LYNBROOK
Practice Address - State:NY
Practice Address - Zip Code:11563-1605
Practice Address - Country:US
Practice Address - Phone:516-764-9726
Practice Address - Fax:516-764-5230
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR013128-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical