Provider Demographics
NPI:1598522724
Name:HIDAKA, YUICHIRO
Entity Type:Individual
Prefix:
First Name:YUICHIRO
Middle Name:
Last Name:HIDAKA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3010-93 YANAGAWA
Mailing Address - Street 2:
Mailing Address - City:KAMISU IBARAKI
Mailing Address - State:IBARAKI
Mailing Address - Zip Code:3140252
Mailing Address - Country:JP
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:THREE KEANEY ROAD
Practice Address - Street 2:SUITE ONE
Practice Address - City:KINGSTON
Practice Address - State:RI
Practice Address - Zip Code:02881
Practice Address - Country:US
Practice Address - Phone:401-874-2051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer