Provider Demographics
NPI:1528049400
Name:WEINREB, YAAKOV Y (MD)
Entity type:Individual
Prefix:
First Name:YAAKOV
Middle Name:Y
Last Name:WEINREB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 NEVINS ST
Mailing Address - Street 2:SUITE 505
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-3514
Mailing Address - Country:US
Mailing Address - Phone:617-782-5316
Mailing Address - Fax:617-783-8017
Practice Address - Street 1:11 NEVINS ST
Practice Address - Street 2:SUITE 505
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-3514
Practice Address - Country:US
Practice Address - Phone:617-782-5316
Practice Address - Fax:617-783-8017
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA155752207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3177696Medicaid
A23825Medicare ID - Type Unspecified
MA3177696Medicaid