Provider Demographics
NPI:1154492908
Name:CONNELLY, SUNI MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:SUNI
Middle Name:MARIE
Last Name:CONNELLY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 HANA HWY
Mailing Address - Street 2:#213
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-2315
Mailing Address - Country:US
Mailing Address - Phone:808-877-5587
Mailing Address - Fax:808-871-8024
Practice Address - Street 1:444 HANA HWY
Practice Address - Street 2:#213
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-2315
Practice Address - Country:US
Practice Address - Phone:808-877-5587
Practice Address - Fax:808-871-8024
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDC959111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000245589OtherHMSA
56424Medicare ID - Type Unspecified