Provider Demographics
NPI:1962004077
Name:NORTH SHORE REHAB LLC
Entity type:Organization
Organization Name:NORTH SHORE REHAB LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:COKER
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, CMP
Authorized Official - Phone:808-319-8389
Mailing Address - Street 1:1088 BISHOP ST STE 4005
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-3199
Mailing Address - Country:US
Mailing Address - Phone:808-319-8389
Mailing Address - Fax:808-756-9549
Practice Address - Street 1:1088 BISHOP ST STE 4005
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-3199
Practice Address - Country:US
Practice Address - Phone:808-319-8389
Practice Address - Fax:808-756-9549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-12
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Multi-Specialty