Provider Demographics
NPI:1659341527
Name:WEINTRAUB GERIATRIC ASSOCIATES, INC PC
Entity Type:Organization
Organization Name:WEINTRAUB GERIATRIC ASSOCIATES, INC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:H
Authorized Official - Last Name:WEINTRAUB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-916-1066
Mailing Address - Street 1:31 FOREST ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02461-1445
Mailing Address - Country:US
Mailing Address - Phone:617-916-1066
Mailing Address - Fax:
Practice Address - Street 1:146 DEAN ST
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-2716
Practice Address - Country:US
Practice Address - Phone:617-916-1300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-24
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MADC3209OtherRAILROAD MEDICARE
MA9735640Medicaid
M21409Medicare ID - Type Unspecified