Healthcare Provider Details

I. General information

NPI: 1134115017
Provider Name (Legal Business Name): GARY WEINSTEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2005
Last Update Date: 04/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3471 5TH AVE SUITE 1115
PITTSBURGH PA
15213-3215
US

IV. Provider business mailing address

211 SPRINGHOUSE LN
PITTSBURGH PA
15238-2512
US

V. Phone/Fax

Practice location:
  • Phone: 412-681-4220
  • Fax: 412-681-4396
Mailing address:
  • Phone: 412-963-1337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number022357-E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: