Provider Demographics
NPI:1255480638
Name:MARK J FERRI DO PROFESSIONAL LLC
Entity Type:Organization
Organization Name:MARK J FERRI DO PROFESSIONAL LLC
Other - Org Name:OHANA OSTEOPATHIC AND WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:J
Authorized Official - Last Name:FERRI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:808-263-4263
Mailing Address - Street 1:122 ONEAWA ST
Mailing Address - Street 2:101
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-2524
Mailing Address - Country:US
Mailing Address - Phone:808-263-4263
Mailing Address - Fax:808-263-4263
Practice Address - Street 1:122 ONEAWA ST
Practice Address - Street 2:101
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2524
Practice Address - Country:US
Practice Address - Phone:808-263-4263
Practice Address - Fax:808-263-4263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI965207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI238238OtherBCBS
HI238238OtherBCBS