Provider Demographics
NPI:1528448222
Name:WEICHBROD, FEIGE R
Entity type:Individual
Prefix:MRS
First Name:FEIGE
Middle Name:R
Last Name:WEICHBROD
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:FEIGE
Other - Middle Name:R
Other - Last Name:WEICHBROD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, CCC- SLP
Mailing Address - Street 1:28 E 9TH ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-1992
Mailing Address - Country:US
Mailing Address - Phone:347-372-9675
Mailing Address - Fax:732-367-4661
Practice Address - Street 1:28 E 9TH ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-1992
Practice Address - Country:US
Practice Address - Phone:347-372-9675
Practice Address - Fax:732-367-4661
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-08
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00436300235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist