Provider Demographics
NPI:1770680704
Name:WESTON PSYCHCARE PA
Entity Type:Organization
Organization Name:WESTON PSYCHCARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SETH
Authorized Official - Middle Name:L
Authorized Official - Last Name:GROBMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:954-385-4696
Mailing Address - Street 1:2771 EXECUTIVE PARK DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331
Mailing Address - Country:US
Mailing Address - Phone:954-385-4696
Mailing Address - Fax:954-385-8385
Practice Address - Street 1:2771 EXECUTIVE PARK DR
Practice Address - Street 2:SUITE 4
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331
Practice Address - Country:US
Practice Address - Phone:954-385-4696
Practice Address - Fax:954-385-8385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty