Provider Demographics
NPI:1306347232
Name:WEINSTOCK, MARGOT J
Entity type:Individual
Prefix:
First Name:MARGOT
Middle Name:J
Last Name:WEINSTOCK
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 1:1095 PARK AVE APT 3B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1154
Mailing Address - Country:US
Mailing Address - Phone:917-806-5480
Mailing Address - Fax:212-879-9372
Practice Address - Street 1:1095 PARK AVE APT 3B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1154
Practice Address - Country:US
Practice Address - Phone:917-806-5480
Practice Address - Fax:212-879-9372
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-26
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool