Provider Demographics
NPI:1427224070
Name:GESIK, NICOLE YUKIKO (DO)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:YUKIKO
Last Name:GESIK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 S KING ST
Mailing Address - Street 2:SUITE 401
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1701
Mailing Address - Country:US
Mailing Address - Phone:808-521-8170
Mailing Address - Fax:
Practice Address - Street 1:1010 S KING ST
Practice Address - Street 2:SUITE 401
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1701
Practice Address - Country:US
Practice Address - Phone:808-521-8170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-05
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDOS-1387207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine