Provider Demographics
NPI:1710350194
Name:KONDO, NINA OI TING (DPT)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:OI TING
Last Name:KONDO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 KAPIOLANI BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-5212
Mailing Address - Country:US
Mailing Address - Phone:808-596-9446
Mailing Address - Fax:808-596-9160
Practice Address - Street 1:770 KAPIOLANI BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-5212
Practice Address - Country:US
Practice Address - Phone:808-596-9446
Practice Address - Fax:808-596-9160
Is Sole Proprietor?:No
Enumeration Date:2015-11-05
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI4090225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist