Provider Demographics
NPI:1649438490
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:301-843-9112
Mailing Address - Street 1:11750 BUSINESS PARK DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20601-2907
Mailing Address - Country:US
Mailing Address - Phone:301-843-9112
Mailing Address - Fax:301-843-9989
Practice Address - Street 1:11750 BUSINESS PARK DR
Practice Address - Street 2:SUITE 103
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20601-2907
Practice Address - Country:US
Practice Address - Phone:301-843-9112
Practice Address - Fax:301-843-9989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
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
MD309LMedicare PIN
MDGO2089Medicare PIN