Provider Demographics
NPI:1003927237
Name:HADLEY, GRAHAM C (PT)
Entity Type:Individual
Prefix:MR
First Name:GRAHAM
Middle Name:C
Last Name:HADLEY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2812B KALIHI ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-3058
Mailing Address - Country:US
Mailing Address - Phone:808-848-5556
Mailing Address - Fax:808-848-5557
Practice Address - Street 1:2812B KALIHI ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-3058
Practice Address - Country:US
Practice Address - Phone:808-848-5556
Practice Address - Fax:808-848-5557
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT - 1461225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI07500801Medicaid
HIK20203-2OtherHMSA, BCBS
HIK20203-2OtherHMSA, BCBS