Provider Demographics
NPI:1154840387
Name:KARP, LEAH (DPT)
Entity Type:Individual
Prefix:DR
First Name:LEAH
Middle Name:
Last Name:KARP
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422 ILIMANO ST
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-1827
Mailing Address - Country:US
Mailing Address - Phone:808-673-3971
Mailing Address - Fax:
Practice Address - Street 1:422 ILIMANO ST
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-1827
Practice Address - Country:US
Practice Address - Phone:808-673-3971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-19
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA263990225100000X
HIHI1050225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIHI1050Medicaid
CA293690Medicaid