Healthcare Provider Details

I. General information

NPI: 1710286232
Provider Name (Legal Business Name): ERIC S WEINBERG RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2011
Last Update Date: 03/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 FUJITEC DR BLDG A
LEBANON OH
45036-8336
US

IV. Provider business mailing address

975 FUJITEC DR BLDG A SUITE 1
LEBANON OH
45036-8336
US

V. Phone/Fax

Practice location:
  • Phone: 513-228-7800
  • Fax: 513-228-7848
Mailing address:
  • Phone: 513-228-7854
  • Fax: 513-228-7848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN-345929
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: