1629216163 NPI number — MRS. GERALDINE M. DORONIO CRNA

Table of content: (NPI 1619644739)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629216163 NPI number — MRS. GERALDINE M. DORONIO CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DORONIO
Provider First Name:
GERALDINE
Provider Middle Name:
M.
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CRNA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MARUHOM
Provider Other First Name:
GERALDINE
Provider Other Middle Name:
E.
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1629216163
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/19/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1946 YOUNG ST
Provider Second Line Business Mailing Address:
SUITE 320
Provider Business Mailing Address City Name:
HONOLULU
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96826-2169
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-973-7330
Provider Business Mailing Address Fax Number:
808-973-7325

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3288 MOANALUA RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96819-1469
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-432-0000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/21/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367500000X , with the licence number:  RN-63206 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)