Provider Demographics
NPI:1104009554
Name:LEITE - AH YO, HARVELEE HEALANI (DC, RPT)
Entity Type:Individual
Prefix:
First Name:HARVELEE
Middle Name:HEALANI
Last Name:LEITE - AH YO
Suffix:
Gender:F
Credentials:DC, RPT
Other - Prefix:DR
Other - First Name:HARVELEE
Other - Middle Name:HEALANI
Other - Last Name:LEITE-AH YO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC, RPT
Mailing Address - Street 1:261 WAIANUENUE AVE
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-2438
Mailing Address - Country:US
Mailing Address - Phone:808-961-5663
Mailing Address - Fax:808-969-3767
Practice Address - Street 1:261 WAIANUENUE AVE
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2438
Practice Address - Country:US
Practice Address - Phone:808-961-5663
Practice Address - Fax:808-969-3767
Is Sole Proprietor?:No
Enumeration Date:2007-12-07
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI597111NR0400X
HIPT - 742225100000X
CAPT 7896225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000QCCPDMedicare PIN
HIU42038Medicare UPIN