Provider Demographics
NPI:1194875955
Name:CATANZARO, ELIZABETH A (MD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:CATANZARO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2060
Mailing Address - Street 2:
Mailing Address - City:KEALAKEKUA
Mailing Address - State:HI
Mailing Address - Zip Code:96750-2060
Mailing Address - Country:US
Mailing Address - Phone:808-323-3107
Mailing Address - Fax:808-323-0012
Practice Address - Street 1:81-6587 MAMALAHOA HWY # C201
Practice Address - Street 2:
Practice Address - City:KEALAKEKUA
Practice Address - State:HI
Practice Address - Zip Code:96750-8133
Practice Address - Country:US
Practice Address - Phone:808-323-3107
Practice Address - Fax:808-323-0012
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD13471207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI529372OtherHMA
HI584525Medicaid
HI0000255901OtherHMSA
HI0000255901OtherHMSA
HI529372OtherHMA