Basic Information
| Provider Information | |||||||||
| NPI: | 1063737005 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SUMIBCAY | ||||||||
| FirstName: | EMMA JOY | ||||||||
| MiddleName: | SERDENIA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1178 KINOOLE ST STE B | ||||||||
| Address2: | |||||||||
| City: | HILO | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967207206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8089691427 | ||||||||
| FaxNumber: | 8089614909 | ||||||||
| Practice Location | |||||||||
| Address1: | 1178 KINOOLE ST STE B | ||||||||
| Address2: | |||||||||
| City: | HILO | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967207206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8089691427 | ||||||||
| FaxNumber: | 8089614909 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/01/2010 | ||||||||
| LastUpdateDate: | 04/01/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN-66265 | HI | Y | Nursing Service Providers | Registered Nurse |
No ID Information.