Provider Demographics
NPI:1922124072
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:410-672-2515
Mailing Address - Street 1:1215 ANNAPOLIS ROAD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ODENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21113
Mailing Address - Country:US
Mailing Address - Phone:410-672-2515
Mailing Address - Fax:301-912-2601
Practice Address - Street 1:1215 ANNAPOLIS ROAD
Practice Address - Street 2:SUITE 103
Practice Address - City:ODENTON
Practice Address - State:MD
Practice Address - Zip Code:21113
Practice Address - Country:US
Practice Address - Phone:410-672-2515
Practice Address - Fax:301-912-2601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2008-05-08
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
MDG02089Medicare PIN
MD309LMedicare PIN