Provider Demographics
NPI:1255584728
Name:SY, JUNE MARIE (PT)
Entity type:Individual
Prefix:
First Name:JUNE MARIE
Middle Name:
Last Name:SY
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 1:4211 WAIALAE AVE STE 303
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-5316
Mailing Address - Country:US
Mailing Address - Phone:845-309-5508
Mailing Address - Fax:
Practice Address - Street 1:4211 WAIALAE AVE STE 303
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-5316
Practice Address - Country:US
Practice Address - Phone:845-309-5508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2024-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT5568225100000X
NY023965-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist