Basic Information
| Provider Information | |||||||||
| NPI: | 1003802976 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COHN | ||||||||
| FirstName: | KEVIN | ||||||||
| MiddleName: | THOMAS | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | HM2/P.T. TEHCNICIAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2223 KALALI ST | ||||||||
| Address2: | |||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968183420 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 480 CENTRAL AVE | ||||||||
| Address2: | |||||||||
| City: | PEARL HARBOR | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968604908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8082578708 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/26/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 374700000X | Y | Nursing Service Related Providers | Technician |
No ID Information.