Healthcare Provider Details

I. General information

NPI: 1063738813
Provider Name (Legal Business Name): DEFENSE FINANCE & ACTG SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2010
Last Update Date: 04/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

691 SCHOFIELD BARRACKS U.S ARMY HEALTH CLINIC BLDG
WAHIAWA HI
96859
US

IV. Provider business mailing address

9 BROOK HILL RD
EAST HADDAM CT
06423-1385
US

V. Phone/Fax

Practice location:
  • Phone: 808-433-8616
  • Fax:
Mailing address:
  • Phone: 860-304-8397
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code286500000X
TaxonomyMilitary Hospital
License Number001655
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code286500000X
TaxonomyMilitary Hospital
License Number13474
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code286500000X
TaxonomyMilitary Hospital
License Number01150
License Number StateRI
# 4
Primary TaxonomyY
Taxonomy Code286500000X
TaxonomyMilitary Hospital
License Number741
License Number StateHI

VIII. Authorized Official

Name: MS. DEIRDRE LYN PETERS
Title or Position: TBI OCCUPATIONAL THERAPIST
Credential: TBI OTR/L, TLP
Phone: 808-433-8616