| Chrysalis Institute | |
|
1350 S King St Ste 325 Honolulu HI 96814-2008 | |
| (808) 591-9116 | |
| (808) 591-9655 |
| Full Name | Chrysalis Institute |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1350 S King St Ste 325, Honolulu, Hawaii |
| Authorized Official Name and Position | David Stein (PRESIDENT) |
| Authorized Official Contact | 8085919116 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chrysalis Institute 1350 S King St Ste 325 Honolulu HI 96814-2008 Ph: (808) 591-9116 | Chrysalis Institute 1350 S King St Ste 325 Honolulu HI 96814-2008 Ph: (808) 591-9116 |
| NPI Number | 1841210341 |
|---|---|
| Provider Enumeration Date | 07/20/2006 |
| Last Update Date | 02/02/2015 |
| Medicare PECOS PAC ID | 3971491150 |
|---|---|
| Medicare Enrollment ID | O20040309000665 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841210341 | NPI | - | NPPES |
| 02161401 | Medicaid | HI | |
| 00R0023920 | Other | HI | BLUE CROSS/ BLUE SHIELD |
| 02161401 | Other | HI | ALOHA CARE |
| MD5728-05 | Other | HI | QHCP/MDX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | MD5728 (Hawaii) | Primary |
| Provider Name | David M Stein |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740386341 PECOS PAC ID: 1951299130 Enrollment ID: I20111027000537 |
| Provider Name | Olaf K Gitter |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1225181332 PECOS PAC ID: 1658539762 Enrollment ID: I20120221000607 |
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