Provider Demographics
NPI:1003155888
Name:HAWAII ISLAND INTERVENTIONAL PAIN MEDICINE, PC
Entity Type:Organization
Organization Name:HAWAII ISLAND INTERVENTIONAL PAIN MEDICINE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSENFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-933-3400
Mailing Address - Street 1:80 PAUAHI ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-3065
Mailing Address - Country:US
Mailing Address - Phone:808-933-3400
Mailing Address - Fax:808-933-3401
Practice Address - Street 1:80 PAUAHI ST
Practice Address - Street 2:SUITE 104
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-3065
Practice Address - Country:US
Practice Address - Phone:808-933-3400
Practice Address - Fax:808-933-3401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-13
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIW25415513-01174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty