| Doctor Name: | KENNETH I WEISS |
| NPI Number: | 1265469282 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSY.D. |
| License Number: | 3881 |
| Business Practice Address: | 115 Main St Suite 2d North Easton, MA - 023561468 |
| Business Phone Number: | 5082387766 |
| Business Fax Number: | 5082305089 |
| Mailing Address: | 115 Main Street, Suite 2d NORTH EASTON |
| State: | MA |
| Postal Code: | 023561443 |
| Phone Number: | 5082387766 |
| Fax Number: | 5082305089 |
| NPI Enumeration Date: | 06/26/2006 |
| NPI Last Update Date: | 05/27/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QV0200X |
| License Number: | 3881 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | VA |
| Taxonomy Definition: | |