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General NPI Number Information
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NPI Number | 1992997266
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Entity Type | Individual
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Provider Name | MICHAEL K MARESCA PT
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Gender | Male
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Dates
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Enumeration Date | 08/10/2007
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Last Update Date | 07/25/2011
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Provider Practice Location Address
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Address Line | 500 ALA MOANA BLVD SUITE 1-302
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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 | 808-284-0824
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Fax | 808-739-0824
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Provider Business Mailing Address
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Address Line | 2258 PALOLO AVE
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City | HONOLULU
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State | HI
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Zip | 96816-3122
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Country | US
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Telephone | 808-284-0824
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Fax | 808-739-0824
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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 | PT - 1588
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License Number State | HI
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