Healthcare Provider Details

I. General information

NPI: 1699742841
Provider Name (Legal Business Name): ANNA URSULA LOENGARD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 08/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2226 LILIHA ST
HONOLULU HI
96817-1600
US

IV. Provider business mailing address

2226 LILIHA ST ST. FRANCIS HOSPICE
HONOLULU HI
96817-1600
US

V. Phone/Fax

Practice location:
  • Phone: 917-657-5740
  • Fax:
Mailing address:
  • Phone: 917-657-5740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number2259481
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: