Provider Demographics
NPI:1154561041
Name:BECKER WEINSTOCK, DEBRA SHARON (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:SHARON
Last Name:BECKER WEINSTOCK
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:SHARON
Other - Last Name:WEINSTOCK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHYSICAL THERAPIST
Mailing Address - Street 1:131 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-4322
Mailing Address - Country:US
Mailing Address - Phone:201-871-9515
Mailing Address - Fax:
Practice Address - Street 1:131 MADISON AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-4322
Practice Address - Country:US
Practice Address - Phone:201-871-9515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-04
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016307174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist