Healthcare Provider Details

I. General information

NPI: 1639795156
Provider Name (Legal Business Name): Z WEINBERG VISION SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2020
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14894 N STATE AVE
MIDDLEFIELD OH
44062-9724
US

IV. Provider business mailing address

28600 ORANGE MEADOW LN
CHAGRIN FALLS OH
44022-1452
US

V. Phone/Fax

Practice location:
  • Phone: 440-632-1695
  • Fax:
Mailing address:
  • Phone: 502-523-4513
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. ZACHERY RYAN WEINBERG
Title or Position: OPTOMETRIST
Credential: OD
Phone: 502-523-4513