Provider Demographics
NPI:1598361222
Name:DR. LEIF WEIG
Entity Type:Organization
Organization Name:DR. LEIF WEIG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LEIF
Authorized Official - Middle Name:
Authorized Official - Last Name:WEIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-614-3414
Mailing Address - Street 1:PO BOX 273543
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33427-3543
Mailing Address - Country:US
Mailing Address - Phone:954-614-3414
Mailing Address - Fax:
Practice Address - Street 1:4800 LINTON BLVD STE E314
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-6500
Practice Address - Country:US
Practice Address - Phone:954-614-3414
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health