Provider Demographics
NPI:1407722416
Name:LIBERTY AUDIOLOGY OF NEW YORK PC
Entity type:Organization
Organization Name:LIBERTY AUDIOLOGY OF NEW YORK PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:WEIGAND
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:347-983-8918
Mailing Address - Street 1:412 LINDEN BLVD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-2818
Mailing Address - Country:US
Mailing Address - Phone:718-833-5867
Mailing Address - Fax:718-833-5866
Practice Address - Street 1:412 LINDEN BLVD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2818
Practice Address - Country:US
Practice Address - Phone:718-833-5867
Practice Address - Fax:718-833-5866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-15
Last Update Date:2025-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty