Provider Demographics
NPI:1518310945
Name:BARBARA A. D'ANNA
Entity Type:Organization
Organization Name:BARBARA A. D'ANNA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:D'ANNA
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:808-772-1199
Mailing Address - Street 1:92-726 ANIPEAHI ST
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-1044
Mailing Address - Country:US
Mailing Address - Phone:808-772-1199
Mailing Address - Fax:
Practice Address - Street 1:2176 LAUWILIWILI ST
Practice Address - Street 2:SUITE 23
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-1881
Practice Address - Country:US
Practice Address - Phone:808-772-1199
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-20
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT-11863261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center