Healthcare Provider Details

I. General information

NPI: 1427967157
Provider Name (Legal Business Name): KAITLYN MICHELLE GIACCONE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5722 KALANIANAOLE HWY
HONOLULU HI
96821-2388
US

IV. Provider business mailing address

7000 HAWAII KAI DR APT 2413
HONOLULU HI
96825-4182
US

V. Phone/Fax

Practice location:
  • Phone: 808-373-3555
  • Fax: 808-373-3666
Mailing address:
  • Phone: 808-373-3555
  • Fax: 808-373-3666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT-6474
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: