Provider Demographics
NPI:1679328918
Name:HURNEY, TIMOTHY THOMAS
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:THOMAS
Last Name:HURNEY
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 1:670 WAIALE RD
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-2375
Mailing Address - Country:US
Mailing Address - Phone:808-868-6002
Mailing Address - Fax:
Practice Address - Street 1:670 WAIALE RD
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-2375
Practice Address - Country:US
Practice Address - Phone:808-868-6002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-19
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care