Provider Demographics
NPI:1649041252
Name:HEATHER L WEBER
Entity type:Organization
Organization Name:HEATHER L WEBER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:L
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:516-287-0798
Mailing Address - Street 1:968 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-4823
Mailing Address - Country:US
Mailing Address - Phone:516-287-0798
Mailing Address - Fax:
Practice Address - Street 1:100 N CENTRE AVE STE 202
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-6301
Practice Address - Country:US
Practice Address - Phone:516-665-1939
Practice Address - Fax:515-266-6132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty