Provider Demographics
NPI:1891869384
Name:WEINTRAUB, RICHARD J (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:J
Last Name:WEINTRAUB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:13 EATON COURT
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:WELLESLEY HILLS
Mailing Address - State:MA
Mailing Address - Zip Code:02481-7600
Mailing Address - Country:US
Mailing Address - Phone:781-431-8686
Mailing Address - Fax:781-431-0399
Practice Address - Street 1:13 EATON COURT
Practice Address - Street 2:2ND FLOOR
Practice Address - City:WELLESLEY HILLS
Practice Address - State:MA
Practice Address - Zip Code:02481-7600
Practice Address - Country:US
Practice Address - Phone:781-431-8686
Practice Address - Fax:781-431-0399
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA334272084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAMO9167Medicare ID - Type Unspecified
A68137Medicare UPIN