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General NPI Number Information
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NPI Number | 1073472049
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Entity Type | Individual
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Provider Name | SAMUEL KEISERMAN
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Gender | Male
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Dates
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Enumeration Date | 01/16/2026
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Last Update Date | 01/16/2026
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Provider Practice Location Address
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Address Line | 555 UNIVERSITY AVE APT 3207
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City | HONOLULU
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State | HI
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Zip | 96826-5007
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Country | US
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Telephone | 516-734-1036
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Fax |
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Provider Business Mailing Address
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Address Line | 555 UNIVERSITY AVE APT 3207
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City | HONOLULU
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State | HI
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Zip | 96826-5007
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Country | US
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Telephone | 516-734-1036
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | APRN-6552
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | APRN-6552
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License Number State | HI
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | APRN-5662
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License Number State | HI
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