Provider Demographics
NPI:1982949244
Name:WEINSTEIN, LYNN ILENE (RPH)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:ILENE
Last Name:WEINSTEIN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4696 WHITEHALL DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-3857
Mailing Address - Country:US
Mailing Address - Phone:216-291-3662
Mailing Address - Fax:
Practice Address - Street 1:4696 WHITEHALL DR
Practice Address - Street 2:
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-3857
Practice Address - Country:US
Practice Address - Phone:216-291-3662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-27
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03114762183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH03114762OtherOHIO STATE BOARD OF PHARMACY