Provider Demographics
NPI:1124885991
Name:NAKAO, NOEL URBANO (COTA/L)
Entity type:Individual
Prefix:
First Name:NOEL
Middle Name:URBANO
Last Name:NAKAO
Suffix:
Gender:M
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3552 PUUKU MAKAI DR
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96818-2812
Mailing Address - Country:US
Mailing Address - Phone:808-649-0650
Mailing Address - Fax:
Practice Address - Street 1:45-090 NAMOKU ST
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-5305
Practice Address - Country:US
Practice Address - Phone:808-247-6211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI262224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant