MEDICARE: DR. DONALD JAY WEINSTEIN PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	1726	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1659326361	OTHER	OH	MEDICARE CP00573

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659326361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD JAY WEINSTEIN PH.D.

Provider Business Mailing Address
First Line	:	25700 SCIENCE PARK DRIVE, SUITE 200
Second Line	:	LANDMARK CENTRE.
City	:	BEACHWOOD
State	:	OH
Zip	:	44122
Country	:	US
Telephone Number	:	216-831-1040
Fax Number	:	216-831-2667

Provider Business Practice Location Address
First Line	:	24100 CHAGRIN BLVD
Second Line	:	SUITE 400
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-5535
Country	:	US
Telephone Number	:	216-831-1040
Fax Number	:	216-831-2667

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	11/09/2016

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Directions to “ DR. DONALD JAY WEINSTEIN PH.D.” Practice Location

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