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General NPI Number Information
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NPI Number | 1437092814
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Entity Type | Individual
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Provider Name | CAITLIN CUSACK
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Gender | Female
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Dates
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Enumeration Date | 04/10/2026
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Last Update Date | 04/10/2026
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Provider Practice Location Address
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Address Line | 86-260 FARRINGTON HWY
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City | WAIANAE
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State | HI
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Zip | 96792-3128
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Country | US
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Telephone | 631-560-8565
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Fax |
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Provider Business Mailing Address
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Address Line | 84-173 NUKEA PL
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City | WAIANAE
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State | HI
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Zip | 96792-1875
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Country | US
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Telephone | 631-560-8565
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 103779
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License Number State | HI
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