Healthcare Provider Details
I. General information
NPI: 1982214755
Provider Name (Legal Business Name): ANDREA SOTOLONGO HEARING SPECIALIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/05/2020
Last Update Date: 10/07/2020
Certification Date: 10/07/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1003 BISHOP ST STE 2700
HONOLULU HI
96813-6475
US
IV. Provider business mailing address
1296 KAPIOLANI BLVD APT 1806
HONOLULU HI
96814-2882
US
V. Phone/Fax
- Phone: 800-346-4112
- Fax:
- Phone: 305-781-4655
- Fax: 844-880-0651
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 237700000X |
| Taxonomy | Hearing Instrument Specialist |
| License Number | 2101002395 |
| License Number State | VA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 237700000X |
| Taxonomy | Hearing Instrument Specialist |
| License Number | HA-308 |
| License Number State | HI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: