Provider Demographics
NPI:1699291658
Name:HAYASHI, SHUNNOSUKE
Entity type:Individual
Prefix:MR
First Name:SHUNNOSUKE
Middle Name:
Last Name:HAYASHI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:567 N 5TH STREET, SCWAM 257
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47809
Mailing Address - Country:US
Mailing Address - Phone:812-237-2088
Mailing Address - Fax:
Practice Address - Street 1:567 N 5TH STREET, SCWAM 257
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47809
Practice Address - Country:US
Practice Address - Phone:812-237-2088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-21
Last Update Date:2017-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer