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General NPI Number Information
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NPI Number | 1457830218
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Entity Type | Individual
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Provider Name | SUJIN AN
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Gender | Female
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Dates
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Enumeration Date | 08/11/2018
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Last Update Date | 03/06/2025
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Provider Practice Location Address
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Address Line | 1650 KANUNU ST APT 606
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City | HONOLULU
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State | HI
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Zip | 96814-2756
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Country | US
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Telephone | 808-864-1882
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Fax |
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Provider Business Mailing Address
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Address Line | 2707 CRESTON AVE APT 6L
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City | BRONX
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State | NY
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Zip | 10468-3625
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Country | US
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Telephone |
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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 | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 716154-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MAT-18090
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License Number State | HI
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