Healthcare Provider Details

I. General information

NPI: 1598701476
Provider Name (Legal Business Name): TONYA MARIE KRATOVIL M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 04/13/2020
Certification Date: 04/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 PUNCHBOWL ST
HONOLULU HI
96813-2499
US

IV. Provider business mailing address

1301 PUNCHBOWL ST
HONOLULU HI
96813-2499
US

V. Phone/Fax

Practice location:
  • Phone: 808-294-3961
  • Fax:
Mailing address:
  • Phone: 808-294-3961
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number19387
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number19387
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: