| Roger A Weiss, Inc | |
|
75-5744 Alii Dr Kailua Kona HI 96740-1784 | |
| (808) 329-7999 | |
| Not Available |
| Full Name | Roger A Weiss, Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 75-5744 Alii Dr, Kailua Kona, Hawaii |
| Authorized Official Name and Position | Roger A Weiss (PSYCHOLOGIST) |
| Authorized Official Contact | 80832979998 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Roger A Weiss, Inc Po Box 3178 Kailua Kona HI 96745-3178 Ph: () - | Roger A Weiss, Inc 75-5744 Alii Dr Kailua Kona HI 96740-1784 Ph: (808) 329-7999 |
| NPI Number | 1033477872 |
|---|---|
| Provider Enumeration Date | 04/30/2012 |
| Last Update Date | 04/30/2012 |
| Medicare PECOS PAC ID | 3678738028 |
|---|---|
| Medicare Enrollment ID | O20120710000233 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033477872 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | PSY-267 (Hawaii) | Primary |
| Provider Name | Roger A Weiss |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1730255241 PECOS PAC ID: 7012172471 Enrollment ID: I20120710000274 |
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