Provider Demographics
NPI:1033233994
Name:WEINSTEIN, RUTH KANOW (PHD)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:KANOW
Last Name:WEINSTEIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15010 SADDLE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-2211
Mailing Address - Country:US
Mailing Address - Phone:301-549-1650
Mailing Address - Fax:
Practice Address - Street 1:600 RIDGELY AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1001
Practice Address - Country:US
Practice Address - Phone:410-266-8555
Practice Address - Fax:410-266-5328
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01772103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG778OtherCAREFIRST
MD6581OtherCAREFIRST
MD6581OtherCAREFIRST
MD111803Medicare UPIN