Provider Demographics
NPI:1255923223
Name:MALLARI, ISAIAH (NP)
Entity type:Individual
Prefix:MR
First Name:ISAIAH
Middle Name:
Last Name:MALLARI
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1108 AUAHI ST APT 1506
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-4965
Mailing Address - Country:US
Mailing Address - Phone:808-888-4800
Mailing Address - Fax:
Practice Address - Street 1:1450 ALA MOANA BLVD # 2230
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4604
Practice Address - Country:US
Practice Address - Phone:808-888-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-10
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI3138363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily