Healthcare Provider Details

I. General information

NPI: 1134446651
Provider Name (Legal Business Name): RUTH K. WEINSTEIN, PHD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2010
Last Update Date: 04/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 OLD SOLOMONS ISLAND RD SUITE 200
ANNAPOLIS MD
21401-3854
US

IV. Provider business mailing address

49 OLD SOLOMONS ISLAND RD SUITE 200
ANNAPOLIS MD
21401-3854
US

V. Phone/Fax

Practice location:
  • Phone: 410-266-8555
  • Fax: 410-266-5328
Mailing address:
  • Phone: 410-266-8555
  • Fax: 410-266-5328

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number01772
License Number StateMD

VIII. Authorized Official

Name: DR. RUTH KANOW WEINSTEIN
Title or Position: CORPORATE OFFICER
Credential: PHD PSYCHOLOGIST
Phone: 301-549-1650