Healthcare Provider Details

I. General information

NPI: 1194012948
Provider Name (Legal Business Name): ANRIADA NASSIF MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANRIADA MEHMETI

II. Dates (important events)

Enumeration Date: 06/30/2011
Last Update Date: 03/22/2026
Certification Date: 03/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

970 N KALAHEO AVE STE C103
KAILUA HI
96734-1871
US

IV. Provider business mailing address

970 N KALAHEO AVE STE C103
KAILUA HI
96734-1871
US

V. Phone/Fax

Practice location:
  • Phone: 808-254-6474
  • Fax: 808-254-6400
Mailing address:
  • Phone: 808-254-6474
  • Fax: 808-254-6400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License NumberQ1242
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD19486
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberQ1242
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: