Provider Demographics
NPI:1285920595
Name:ADVANCED PSYCHIATRIC THERAPEUTICS
Entity type:Organization
Organization Name:ADVANCED PSYCHIATRIC THERAPEUTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:D
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-261-7792
Mailing Address - Street 1:1164 BISHOP ST STE 1611
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2816
Mailing Address - Country:US
Mailing Address - Phone:808-261-7792
Mailing Address - Fax:808-792-0034
Practice Address - Street 1:1164 BISHOP ST STE 1611
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2816
Practice Address - Country:US
Practice Address - Phone:808-261-7792
Practice Address - Fax:808-792-0034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-24
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI156322084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty