Provider Demographics
NPI:1770537938
Name:DENEEVE BAUM, ERIN (PT)
Entity type:Individual
Prefix:MS
First Name:ERIN
Middle Name:
Last Name:DENEEVE BAUM
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 1:94-1477 WAIPIO UKA ST.
Mailing Address - Street 2:G206
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-4667
Mailing Address - Country:US
Mailing Address - Phone:808-754-6169
Mailing Address - Fax:
Practice Address - Street 1:98-211 PALI MOMI ST
Practice Address - Street 2:ROOM 707
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701
Practice Address - Country:US
Practice Address - Phone:808-450-9250
Practice Address - Fax:888-965-6583
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1940225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH54550Medicare PIN
HI1940OtherPHYSICAL THERAPY LICENSE