Provider Demographics
NPI:1912612318
Name:RONALD HIROKAWA, MD
Entity Type:Organization
Organization Name:RONALD HIROKAWA, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-777-7500
Mailing Address - Street 1:1 LONG WHARF DRIVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511
Mailing Address - Country:US
Mailing Address - Phone:203-777-7500
Mailing Address - Fax:203-777-8469
Practice Address - Street 1:ONE LONG WHARF DRIVE
Practice Address - Street 2:SUITE 302
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511
Practice Address - Country:US
Practice Address - Phone:203-777-7500
Practice Address - Fax:203-777-8469
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RONALD HIROKAWA, MD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-01-19
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001259142Medicaid