Healthcare Provider Details

I. General information

NPI: 1154957496
Provider Name (Legal Business Name): ZAHAVA N CZARA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2020
Last Update Date: 03/18/2020
Certification Date: 03/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

68-139 AU ST
WAIALUA HI
96791-8405
US

IV. Provider business mailing address

150 HAMAKUA DR # 337
KAILUA HI
96734-2825
US

V. Phone/Fax

Practice location:
  • Phone: 808-796-6495
  • Fax:
Mailing address:
  • Phone: 808-796-6495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number10463
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: