Healthcare Provider Details

I. General information

NPI: 1770917239
Provider Name (Legal Business Name): MARY FINNERTY HUGHES DPT, OCS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARY JOAN FINNERTY DPT, OCS

II. Dates (important events)

Enumeration Date: 09/02/2013
Last Update Date: 09/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95-720 LANIKUHANA AVE #140
MILILANI HI
96789-2985
US

IV. Provider business mailing address

95-720 LANIKUHANA AVE #140
MILILANI HI
96789-2985
US

V. Phone/Fax

Practice location:
  • Phone: 808-623-6414
  • Fax:
Mailing address:
  • Phone: 808-623-6414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT40206
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT60028456
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT4202
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: