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General NPI Number Information
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NPI Number | 1700641610
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Entity Type | Individual
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Provider Name | JERICHO EMILE TOMBO PIANSAY PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 02/20/2024
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 95-1105 AINAMAKUA DR STE 203
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City | MILILANI
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State | HI
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Zip | 96789-6313
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Country | US
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Telephone | 808-381-8947
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Fax | 800-586-4356
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Provider Business Mailing Address
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Address Line | 1401 S BERETANIA ST STE 550
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City | HONOLULU
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State | HI
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Zip | 96814-1880
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Country | US
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Telephone | 808-381-8947
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Fax | 800-586-4356
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5873
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License Number State | HI
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