Provider Demographics
NPI:1043673296
Name:LAGUNDI, ATHENA LYNN (PT)
Entity Type:Individual
Prefix:
First Name:ATHENA LYNN
Middle Name:
Last Name:LAGUNDI
Suffix:
Gender:F
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:PO BOX 970277
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-0277
Mailing Address - Country:US
Mailing Address - Phone:808-391-7678
Mailing Address - Fax:
Practice Address - Street 1:94-229 WAIPAHU DEPOT ST
Practice Address - Street 2:SUITE 304
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-3031
Practice Address - Country:US
Practice Address - Phone:808-391-7678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-04
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT-41092251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic