Healthcare Provider Details

I. General information

NPI: 1285977850
Provider Name (Legal Business Name): GESIK PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2013
Last Update Date: 03/16/2021
Certification Date: 10/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

677 ALA MOANA BLVD STE 725
HONOLULU HI
96813-5417
US

IV. Provider business mailing address

677 ALA MOANA BLVD STE 725
HONOLULU HI
96813-5417
US

V. Phone/Fax

Practice location:
  • Phone: 808-734-0010
  • Fax: 808-734-0013
Mailing address:
  • Phone: 808-734-0010
  • Fax: 808-734-0013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number3507
License Number StateHI

VIII. Authorized Official

Name: MARI KEHAULANI PUNZAL GESIK
Title or Position: OFFICE MANAGER
Credential:
Phone: 808-734-0010