| Atlanta Clinical Group | |
|
2795 W Main St Ste 25a Snellville GA 30078-3075 | |
| (770) 982-2352 | |
| (770) 982-8848 |
| Full Name | Atlanta Clinical Group |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 2795 W Main St Ste 25a, Snellville, Georgia |
| Authorized Official Name and Position | Jay Alan Weinstein (OWNER PRESIDENT) |
| Authorized Official Contact | 7709822352 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Atlanta Clinical Group 2795 W Main St Ste 25a Snellville GA 30078-3075 Ph: (770) 982-2352 | Atlanta Clinical Group 2795 W Main St Ste 25a Snellville GA 30078-3075 Ph: (770) 982-2352 |
| NPI Number | 1194757492 |
|---|---|
| Provider Enumeration Date | 07/07/2006 |
| Last Update Date | 03/25/2011 |
| Medicare PECOS PAC ID | 5991773434 |
|---|---|
| Medicare Enrollment ID | O20040922000322 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194757492 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Primary |
| 103T00000X | Psychologist | (* (Not Available)) | Secondary |
| Provider Name | Jay A Weinstein |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1336358688 PECOS PAC ID: 6709854243 Enrollment ID: I20050103000134 |
| Provider Name | Edward M Vega |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518986108 PECOS PAC ID: 7012088651 Enrollment ID: I20080625000296 |
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