Provider Demographics
NPI:1295082394
Name:JANICE K. FRIEND, M.D., INC.
Entity type:Organization
Organization Name:JANICE K. FRIEND, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:K
Authorized Official - Last Name:FRIEND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-254-9594
Mailing Address - Street 1:970 N KALAHEO AVE
Mailing Address - Street 2:C314
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-1866
Mailing Address - Country:US
Mailing Address - Phone:808-254-9594
Mailing Address - Fax:808-254-9519
Practice Address - Street 1:970 N KALAHEO AVE
Practice Address - Street 2:C314
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-1866
Practice Address - Country:US
Practice Address - Phone:808-254-9594
Practice Address - Fax:808-254-9519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-07
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD53372084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI02240602Medicaid
HIH51990Medicare PIN
HIA50510Medicare UPIN