Provider Demographics
NPI:1770233496
Name:HIRANO, KAZUYA (ATS)
Entity Type:Individual
Prefix:MR
First Name:KAZUYA
Middle Name:
Last Name:HIRANO
Suffix:
Gender:M
Credentials:ATS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 W SHERIDAN AVE
Mailing Address - Street 2:
Mailing Address - City:ANNVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17003-1242
Mailing Address - Country:US
Mailing Address - Phone:207-233-8430
Mailing Address - Fax:
Practice Address - Street 1:11 W SHERIDAN AVE
Practice Address - Street 2:
Practice Address - City:ANNVILLE
Practice Address - State:PA
Practice Address - Zip Code:17003-1242
Practice Address - Country:US
Practice Address - Phone:207-233-8430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-25
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer