Provider Demographics
NPI:1295895415
Name:WEINBERG, CLARA C (PT)
Entity type:Individual
Prefix:
First Name:CLARA
Middle Name:C
Last Name:WEINBERG
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 NORTHERN BLVD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5309
Mailing Address - Country:US
Mailing Address - Phone:516-482-6893
Mailing Address - Fax:516-482-6946
Practice Address - Street 1:935 NORTHERN BLVD
Practice Address - Street 2:SUITE 301
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5309
Practice Address - Country:US
Practice Address - Phone:516-482-6893
Practice Address - Fax:516-482-6946
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006273-1225100000X
FLPT1931225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
P620732OtherOXFORD HEALTH PLANS
20156POtherHIP
Q54292OtherEMPIRE BLUE CROSS BLUE SH
NYQ54291Medicare ID - Type Unspecified
Q54292OtherEMPIRE BLUE CROSS BLUE SH