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General NPI Number Information
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NPI Number | 1518688928
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Entity Type | Organization
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Legal Business Name | NOVOTELEHEALTH HI, INC.
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Dates
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Enumeration Date | 09/06/2022
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Last Update Date | 09/06/2022
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Provider Practice Location Address
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Address Line | 500 ALA MOANA BLVD
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City | HONOLULU
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State | HI
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Zip | 96813-4920
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Country | US
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Telephone | 203-528-5643
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Fax |
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Provider Business Mailing Address
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Address Line | 1816 CORONADO ST
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City | IDAHO FALLS
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State | ID
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Zip | 83404-7453
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Country | US
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Telephone | 203-528-5643
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CRISTINA SANCHEZ-JAQUEZ
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Credential | MD
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Telephone | 203-528-5643
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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