Healthcare Provider Details

I. General information

NPI: 1104372010
Provider Name (Legal Business Name): SUZUKI PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2016
Last Update Date: 03/20/2024
Certification Date: 05/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3972 OLD PALI RD (HOME OFFICE, DO NOT PUBLISH) (HOME OFFICE, DO NOT PUBLISH)
HONOLULU HI
96817-1009
US

IV. Provider business mailing address

3972 OLD PALI RD
HONOLULU HI
96817-1009
US

V. Phone/Fax

Practice location:
  • Phone: 808-348-1495
  • Fax:
Mailing address:
  • Phone: 808-389-1968
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number15073
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number15073
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number15073
License Number StateHI
# 4
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RIKA SUZUKI
Title or Position: PSYCHIATRIST
Credential: M.D.
Phone: 808-389-1968