Provider Demographics
NPI:1205063062
Name:MEADE-WEINIG, MARY JOSEPH
Entity type:Individual
Prefix:MS
First Name:MARY JOSEPH
Middle Name:
Last Name:MEADE-WEINIG
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 1:25 SUTTON PL
Mailing Address - Street 2:APT 9
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-2423
Mailing Address - Country:US
Mailing Address - Phone:212-223-0231
Mailing Address - Fax:212-754-5830
Practice Address - Street 1:25 SUTTON PL
Practice Address - Street 2:APT 9
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-2423
Practice Address - Country:US
Practice Address - Phone:212-223-0231
Practice Address - Fax:212-754-5830
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-18
Last Update Date:2009-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013024-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist