Provider Demographics
NPI:1770940413
Name:SAGUIGUIT, MARC JAYSON NALUNDASAN (PT)
Entity type:Individual
Prefix:MR
First Name:MARC JAYSON
Middle Name:NALUNDASAN
Last Name:SAGUIGUIT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 290
Mailing Address - Street 2:15-3091 NAELE ROAD
Mailing Address - City:PAHOA
Mailing Address - State:HI
Mailing Address - Zip Code:96778-0290
Mailing Address - Country:US
Mailing Address - Phone:808-640-4535
Mailing Address - Fax:
Practice Address - Street 1:15-3091 NAELE ROAD
Practice Address - Street 2:
Practice Address - City:PAHOA
Practice Address - State:HI
Practice Address - Zip Code:96778-0290
Practice Address - Country:US
Practice Address - Phone:808-640-4535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-26
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039851225100000X
HI4246225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist