Provider Demographics
NPI:1558708560
Name:CHERYL E. AYABE, O.D., INC.
Entity Type:Organization
Organization Name:CHERYL E. AYABE, O.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:MILANIO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:808-879-7788
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-0190
Mailing Address - Country:US
Mailing Address - Phone:808-879-7788
Mailing Address - Fax:
Practice Address - Street 1:1280 S KIHEI RD STE 204
Practice Address - Street 2:
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-8240
Practice Address - Country:US
Practice Address - Phone:808-879-7788
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI247152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000PGBGDMedicare UPIN