Provider Demographics
NPI:1891190252
Name:WEINSTEIN EYE ASSOCIATES, PA
Entity Type:Organization
Organization Name:WEINSTEIN EYE ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:I
Authorized Official - Last Name:WEINSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:301-912-5252
Mailing Address - Street 1:10700 TOWN CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:DUNKIRK
Mailing Address - State:MD
Mailing Address - Zip Code:20754-2736
Mailing Address - Country:US
Mailing Address - Phone:443-550-1800
Mailing Address - Fax:443-550-1810
Practice Address - Street 1:1215 ANNAPOLIS RD
Practice Address - Street 2:SUITE 103
Practice Address - City:ODENTON
Practice Address - State:MD
Practice Address - Zip Code:21113-1344
Practice Address - Country:US
Practice Address - Phone:301-912-5252
Practice Address - Fax:301-912-2601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-28
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA1142152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
309LMedicare PIN
MDG02089W01Medicare PIN
MDG02089Medicare PIN
MDU27886Medicare UPIN
MD309L672BMedicare PIN