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General NPI Number Information
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NPI Number | 1740337203
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Entity Type | Individual
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Provider Name | MARIA ROSARIO GERVACIO MABINI M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 09/28/2020
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Provider Practice Location Address
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Address Line | 1833 KALAKAUA AVE STE 206
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City | HONOLULU
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State | HI
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Zip | 96815-1500
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Country | US
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Telephone | 808-393-8456
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Fax | 808-676-5890
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Provider Business Mailing Address
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Address Line | PO BOX 235227
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City | HONOLULU
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State | HI
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Zip | 96823-3503
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Country | US
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Telephone | 808-393-8456
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Fax | 808-676-5890
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD-19987
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License Number State | HI
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