Provider Demographics
NPI:1881641330
Name:ALFARO, PRISCILLA JEANNE (MD)
Entity Type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:JEANNE
Last Name:ALFARO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1319 PUNAHOU ST
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-1001
Mailing Address - Country:US
Mailing Address - Phone:808-955-7845
Mailing Address - Fax:808-946-3071
Practice Address - Street 1:1319 PUNAHOU ST
Practice Address - Street 2:SUITE 1100
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1001
Practice Address - Country:US
Practice Address - Phone:808-955-7845
Practice Address - Fax:808-946-3071
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI7907208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics