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NPI Code Detail

MEDICARE: JUDD BOLOKER M.D.

MEDICARE: JUDD BOLOKER M.D.
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
12080N0001XNeonatal-Perinatal Medicine PhysicianMA076064NJ
22080N0001XNeonatal-Perinatal Medicine PhysicianMD-15619HI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255334579
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUDD BOLOKER M.D.
Provider Business Mailing Address
First Line : 3288 MOANALUA RD
Second Line :
City : HONOLULU
State : HI
Zip : 96819-1469
Country : US
Telephone Number : 808-432-0000
Fax Number :
Provider Business Practice Location Address
First Line : 3288 MOANALUA RD
Second Line :
City : HONOLULU
State : HI
Zip : 96819-1469
Country : US
Telephone Number : 808-432-0000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2005
Last Update Date : 05/27/2021

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