Provider Demographics
NPI:1245943604
Name:WEINBERG, ORTAL
Entity type:Individual
Prefix:
First Name:ORTAL
Middle Name:
Last Name:WEINBERG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 MAMARONECK AVE APT 828
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-6406
Mailing Address - Country:US
Mailing Address - Phone:914-826-7953
Mailing Address - Fax:
Practice Address - Street 1:300 MAMARONECK AVE APT 828
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-6406
Practice Address - Country:US
Practice Address - Phone:914-826-7953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-30
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty