Provider Demographics
NPI:1952185316
Name:WEINBERGER, BREINDY (MS)
Entity Type:Individual
Prefix:
First Name:BREINDY
Middle Name:
Last Name:WEINBERGER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:642 STIRLING AVE BSMT
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-3637
Mailing Address - Country:US
Mailing Address - Phone:908-910-0967
Mailing Address - Fax:
Practice Address - Street 1:642 STIRLING AVE BSMT
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-3637
Practice Address - Country:US
Practice Address - Phone:908-910-0967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-24
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-23-67112103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst