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General NPI Number Information
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NPI Number | 1477922185
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Entity Type | Organization
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Legal Business Name | HAWAII PM&R
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Dates
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Enumeration Date | 09/23/2015
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Last Update Date | 09/23/2015
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Provider Practice Location Address
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Address Line | 1125 YOUNG ST APT 806
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City | HONOLULU
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State | HI
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Zip | 96814-1972
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Country | US
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Telephone | 808-931-9167
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Fax |
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Provider Business Mailing Address
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Address Line | 1125 YOUNG ST APT 806
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City | HONOLULU
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State | HI
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Zip | 96814-1972
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Country | US
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Telephone | 808-931-9167
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. TAMARA KOLLAROVA
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Credential | M.D.
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Telephone | 808-931-9167
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 17167
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License Number State | HI
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