Provider Demographics
NPI:1225124977
Name:PINCUS, DAVID I (DMH)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:I
Last Name:PINCUS
Suffix:
Gender:M
Credentials:DMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12429 CEDAR RD
Mailing Address - Street 2:STE 2
Mailing Address - City:CLEVELAND HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44106-3199
Mailing Address - Country:US
Mailing Address - Phone:216-791-1414
Mailing Address - Fax:216-791-1414
Practice Address - Street 1:12429 CEDAR RD
Practice Address - Street 2:STE 2
Practice Address - City:CLEVELAND HTS
Practice Address - State:OH
Practice Address - Zip Code:44106-3199
Practice Address - Country:US
Practice Address - Phone:216-791-1414
Practice Address - Fax:216-791-1414
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3878103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0927573Medicaid
OHCP01461Medicare ID - Type UnspecifiedPSYCHOLOGIST
OHPI4263061Medicare PIN