Provider Demographics
NPI:1679869416
Name:KENISKY, JAMES KIM (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:KIM
Last Name:KENISKY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2977 ALA ILIMA ST APT 405
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96818-2531
Mailing Address - Country:US
Mailing Address - Phone:254-423-1501
Mailing Address - Fax:
Practice Address - Street 1:2977 ALA ILIMA ST APT 405
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96818-2531
Practice Address - Country:US
Practice Address - Phone:254-423-1501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-20
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS014668183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist