Provider Demographics
NPI:1285721258
Name:PILLEN, BART L (PHD)
Entity type:Individual
Prefix:DR
First Name:BART
Middle Name:L
Last Name:PILLEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1319 PUNAHOU ST
Mailing Address - Street 2:SUITE 950
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-1001
Mailing Address - Country:US
Mailing Address - Phone:808-983-6100
Mailing Address - Fax:808-983-6105
Practice Address - Street 1:1319 PUNAHOU ST
Practice Address - Street 2:SUITE 950
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1001
Practice Address - Country:US
Practice Address - Phone:808-983-6100
Practice Address - Fax:808-983-6105
Is Sole Proprietor?:No
Enumeration Date:2006-10-09
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY-760103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical