Provider Demographics
NPI:1518946334
Name:STEIN, TINA R (MD)
Entity Type:Individual
Prefix:MRS
First Name:TINA
Middle Name:R
Last Name:STEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:TINA
Other - Middle Name:R
Other - Last Name:WEINGRAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1068 W BALTIMORE PIKE
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063
Mailing Address - Country:US
Mailing Address - Phone:610-891-3388
Mailing Address - Fax:610-891-3680
Practice Address - Street 1:1068 W BALTIMORE PIKE
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063
Practice Address - Country:US
Practice Address - Phone:610-891-3388
Practice Address - Fax:610-891-3680
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD022944E2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B31308Medicare UPIN
PAWE008060Medicare ID - Type Unspecified