Provider Demographics
NPI:1356785547
Name:VINCENT J. NIP, M.D., INC
Entity type:Organization
Organization Name:VINCENT J. NIP, M.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:J
Authorized Official - Last Name:NIP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-538-1050
Mailing Address - Street 1:1380 LUSITANA STREET
Mailing Address - Street 2:#808
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813
Mailing Address - Country:US
Mailing Address - Phone:808-538-1050
Mailing Address - Fax:808-538-0108
Practice Address - Street 1:1380 LUSITANA ST
Practice Address - Street 2:SUITE 808
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2449
Practice Address - Country:US
Practice Address - Phone:808-538-1050
Practice Address - Fax:808-538-0108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-18
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI5596208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIF00803Medicare UPIN