Provider Demographics
NPI:1427491448
Name:CORREA, GENEVIEVE F (PT, DPT)
Entity type:Individual
Prefix:
First Name:GENEVIEVE
Middle Name:F
Last Name:CORREA
Suffix:
Gender:F
Credentials:PT, DPT
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 398
Mailing Address - Street 2:
Mailing Address - City:KAUNAKAKAI
Mailing Address - State:HI
Mailing Address - Zip Code:96748-0398
Mailing Address - Country:US
Mailing Address - Phone:808-862-6787
Mailing Address - Fax:808-762-1318
Practice Address - Street 1:93 ALA MALAMA AVE
Practice Address - Street 2:BUILDING B UNIT A
Practice Address - City:KAUNAKAKAI
Practice Address - State:HI
Practice Address - Zip Code:96748
Practice Address - Country:US
Practice Address - Phone:808-862-6787
Practice Address - Fax:808-762-1318
Is Sole Proprietor?:No
Enumeration Date:2013-04-09
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39669225100000X
HI4819225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist