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General NPI Number Information
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NPI Number | 1952034928
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Entity Type | Organization
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Legal Business Name | SLATE AESTHETICS LLC
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Dates
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Enumeration Date | 07/06/2022
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Last Update Date | 08/06/2022
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Provider Practice Location Address
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Address Line | 1441 KAPIOLANI BLVD
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City | HONOLULU
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State | HI
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Zip | 96814-4402
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Country | US
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Telephone | 505-433-1216
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Fax |
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Provider Business Mailing Address
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Address Line | 1504 THURSTON AVE
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City | HONOLULU
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State | HI
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Zip | 96822-3701
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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 | OWNER
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Name | MONICA ZELKOWSKI
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Credential | APRN
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Telephone | 505-433-1216
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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