Provider Demographics
NPI:1720388770
Name:WEISBROT, MALKA E (OTR/L)
Entity Type:Individual
Prefix:
First Name:MALKA
Middle Name:E
Last Name:WEISBROT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:734 EAST 7TH STREET
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NJ
Mailing Address - Zip Code:11218
Mailing Address - Country:US
Mailing Address - Phone:347-415-2740
Mailing Address - Fax:
Practice Address - Street 1:734 E 7TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-5904
Practice Address - Country:US
Practice Address - Phone:347-415-2740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015457-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist