Provider Demographics
NPI:1629307897
Name:DR. STEPHEN A TAREK INC
Entity Type:Organization
Organization Name:DR. STEPHEN A TAREK INC
Other - Org Name:MANOA CHIROPRACTIC AND THERAPEUTIC MASSAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LORNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MERCADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-988-6113
Mailing Address - Street 1:2851 E MANOA RD
Mailing Address - Street 2:SUITE 1-205
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822-1858
Mailing Address - Country:US
Mailing Address - Phone:808-988-6113
Mailing Address - Fax:808-988-5637
Practice Address - Street 1:2851 E MANOA RD
Practice Address - Street 2:SUITE 1-205
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96822-1858
Practice Address - Country:US
Practice Address - Phone:808-988-6113
Practice Address - Fax:808-988-5637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-16
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty