Provider Demographics
NPI:1639943178
Name:CIMINO, ELISE
Entity Type:Individual
Prefix:
First Name:ELISE
Middle Name:
Last Name:CIMINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 ALA WAI BLVD APT 2907
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-2407
Mailing Address - Country:US
Mailing Address - Phone:339-234-3124
Mailing Address - Fax:
Practice Address - Street 1:2211 ALA WAI BLVD APT 2907
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-2407
Practice Address - Country:US
Practice Address - Phone:339-234-3124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist