Provider Demographics
NPI:1831229061
Name:WEINBERG, CARL WILLIAM (PSYA)
Entity type:Individual
Prefix:MR
First Name:CARL
Middle Name:WILLIAM
Last Name:WEINBERG
Suffix:
Gender:M
Credentials:PSYA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 W 58TH ST
Mailing Address - Street 2:SUITE 6C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-2145
Mailing Address - Country:US
Mailing Address - Phone:212-581-4070
Mailing Address - Fax:
Practice Address - Street 1:350 W 50TH ST
Practice Address - Street 2:SUITE 2KK
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-6664
Practice Address - Country:US
Practice Address - Phone:212-581-4070
Practice Address - Fax:646-476-5425
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000353102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst