Provider Demographics
NPI:1881168755
Name:ANI-ANGUAY, ARIEL
Entity type:Individual
Prefix:
First Name:ARIEL
Middle Name:
Last Name:ANI-ANGUAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94-689 FARRINGTON HWY
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-3015
Mailing Address - Country:US
Mailing Address - Phone:808-676-7700
Mailing Address - Fax:808-676-7708
Practice Address - Street 1:94-689 FARRINGTON HWY
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-3015
Practice Address - Country:US
Practice Address - Phone:808-676-7700
Practice Address - Fax:808-676-7708
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-14
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT-15555225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty