Provider Demographics
NPI:1619308996
Name:TAKAO, HIROYUKI
Entity Type:Individual
Prefix:
First Name:HIROYUKI
Middle Name:
Last Name:TAKAO
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 1:1-4-20 JINGUMAE SHIBUYAKU
Mailing Address - Street 2:1304 PARKCOURT JINGUMAE
Mailing Address - City:TOKYO
Mailing Address - State:TOKYO
Mailing Address - Zip Code:150001
Mailing Address - Country:JP
Mailing Address - Phone:813903-047-6381
Mailing Address - Fax:
Practice Address - Street 1:3-25-8 NISHISHINBASHI MINATO-KU
Practice Address - Street 2:
Practice Address - City:TOKYO
Practice Address - State:TOKYO
Practice Address - Zip Code:1058461
Practice Address - Country:JP
Practice Address - Phone:8133-433-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-11
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic