MEDICARE: MR. ERIC JOHN FIALKOWSKI R.T. (R) ARRT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	247200000X	Other Technician

General Provider Information

NPI Number	:	1043319502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ERIC JOHN FIALKOWSKI R.T. (R) ARRT

Provider Business Mailing Address
First Line	:	400 SAND ISLAND ACCESS RD.
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96819
Country	:	US
Telephone Number	:	808-842-2930
Fax Number	:	808-842-2956

Provider Business Practice Location Address
First Line	:	400 SAND ISLAND PKWY
Second Line	:	ISC MEDICAL
City	:	HONOLULU
State	:	HI
Zip	:	96819-4326
Country	:	US
Telephone Number	:	808-842-2930
Fax Number	:	808-842-2956

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	02/04/2013

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