Healthcare Provider Details

I. General information

NPI: 1023929189
Provider Name (Legal Business Name): CRAFT MEDICAL, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1552 ALA AOLOA LOOP
HONOLULU HI
96819
US

IV. Provider business mailing address

2248 BROADWAY # 1684
NEW YORK NY
10024-5805
US

V. Phone/Fax

Practice location:
  • Phone: 914-787-9561
  • Fax:
Mailing address:
  • Phone: 914-787-9561
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. TAKASHI NAKAMURA
Title or Position: PRESIDENT, SECRETARY, TREASURER
Credential: MD
Phone: 808-258-2370