Provider Demographics
NPI:1891153037
Name:KITAZUMI, KAY (PT)
Entity Type:Individual
Prefix:
First Name:KAY
Middle Name:
Last Name:KITAZUMI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 NIUIKI CIR
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96821-2349
Mailing Address - Country:US
Mailing Address - Phone:808-351-6659
Mailing Address - Fax:
Practice Address - Street 1:5722 KALANIANAOLE HWY
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96821-2388
Practice Address - Country:US
Practice Address - Phone:808-373-3555
Practice Address - Fax:808-373-3666
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-02
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT1972225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist