Provider Demographics
NPI:1497882278
Name:NAKAMOTO, HARVEY M (PT)
Entity Type:Individual
Prefix:
First Name:HARVEY
Middle Name:M
Last Name:NAKAMOTO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99-128 AIEA HEIGHTS DR
Mailing Address - Street 2:SUITE 207
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-3968
Mailing Address - Country:US
Mailing Address - Phone:808-487-0487
Mailing Address - Fax:808-486-8674
Practice Address - Street 1:99-128 AIEA HEIGHTS DR
Practice Address - Street 2:SUITE 207
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-3968
Practice Address - Country:US
Practice Address - Phone:808-487-0487
Practice Address - Fax:808-486-8674
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI548225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIOOOOCBBDJMedicare ID - Type Unspecified