Susannah Weinbaum, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

011229-1 Issued in NY

Practice address

14461 Roosevelt Ave
Flushing, NY 11354-6252

Phone

(718) 939-8700

NPI assigned

May 10, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Shield of David, Inc.

  • Clinic/Center
  • Bayside, NY
  • NPI 1184661290
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285848903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 BAY AVE",
            "city": "SEA CLIFF",
            "state": "NY",
            "postal_code": "115791008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14461 ROOSEVELT AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113546252",
            "telephone_number": "718-939-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINBAUM",
        "first_name": "SUSANNAH",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "011229-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Weill Medical College of Cornell University
• Weimin Medical PC
• Weimin Qu MD PC
• Weina Chen D.D.S. P.C.
• Frederic Weinbaum, M.D.
• Chaya Weinberg, M.S.
• Helen Weinberg, DDS
• Dina Weiner
• Leo Weinreich, MD
• Alla Weinstein, LCSW

• Speech-Language Pathologist in Flushing, NY
• Providers in Flushing, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.