Provider Demographics
NPI:1710587738
Name:TONG, LAWRENCE W
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:W
Last Name:TONG
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 1:801 KAHEKA ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-3798
Mailing Address - Country:US
Mailing Address - Phone:808-973-6663
Mailing Address - Fax:808-973-6663
Practice Address - Street 1:801 KAHEKA ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-3798
Practice Address - Country:US
Practice Address - Phone:808-973-6663
Practice Address - Fax:808-973-6656
Is Sole Proprietor?:No
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPH-812183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist