Provider Demographics
NPI:1891130852
Name:GAJIEV, ELNUR (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ELNUR
Middle Name:
Last Name:GAJIEV
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 831153
Mailing Address - Street 2:
Mailing Address - City:PEPEEKEO
Mailing Address - State:HI
Mailing Address - Zip Code:96783-1072
Mailing Address - Country:US
Mailing Address - Phone:347-602-2596
Mailing Address - Fax:
Practice Address - Street 1:28-1672 OLD MAMALAHOA HWY
Practice Address - Street 2:BACK BUILDING, 2ND FLOOR
Practice Address - City:HONOMU
Practice Address - State:HI
Practice Address - Zip Code:96728
Practice Address - Country:US
Practice Address - Phone:347-602-2596
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-03
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist