Healthcare Provider Details

I. General information

NPI: 1265557714
Provider Name (Legal Business Name): NICHOLAS KEN SEKIYA DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 02/22/2024
Certification Date: 02/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 S BERETANIA ST STE 610
HONOLULU HI
96814-1873
US

IV. Provider business mailing address

1401 S BERETANIA ST STE 610
HONOLULU HI
96814-1873
US

V. Phone/Fax

Practice location:
  • Phone: 808-691-4211
  • Fax:
Mailing address:
  • Phone: 808-691-4211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT-3781
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: