1093911869 NPI number — THE HAWAII NEUROPSYCHOLOGY CENTER, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093911869 NPI number — THE HAWAII NEUROPSYCHOLOGY CENTER, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE HAWAII NEUROPSYCHOLOGY CENTER, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1093911869
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
520 LUNALILO HOME RD UNIT 5403
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HONOLULU
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96825-1726
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-395-6766
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1188 BISHOP ST
Provider Second Line Business Practice Location Address:
SUITE #2701
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96813-3301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-585-9494
Provider Business Practice Location Address Fax Number:
808-585-9414
Provider Enumeration Date:
06/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
LIKEWISE
Authorized Official First Name:
ROGER
Authorized Official Middle Name:
LEWIS
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
808-585-9494

Provider Taxonomy Codes

  • Taxonomy code: 103G00000X , with the licence number:  954 , 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)





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