Provider Demographics
NPI:1265296222
Name:SZOZDA, JEFFREY II (PT)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:
Last Name:SZOZDA
Suffix:II
Gender:M
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:PO BOX 2607
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-7607
Mailing Address - Country:US
Mailing Address - Phone:586-246-7937
Mailing Address - Fax:
Practice Address - Street 1:330 OHUKAI RD STE 103
Practice Address - Street 2:
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-7058
Practice Address - Country:US
Practice Address - Phone:808-385-4867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-09
Last Update Date:2024-04-19
Deactivation Date:2024-02-13
Deactivation Code:
Reactivation Date:2024-02-27
Provider Licenses
StateLicense IDTaxonomies
HIPT-58742251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic